Individual provider Active NPI

Michael Alt, DO

  • Neurology Physician
  • Louisville, KY
National Provider Identifier
1740227255
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
02245 Issued in KY
Practice address
2934 Breckenridge LN Ste 2
Louisville, KY 40220-3903
Phone
(502) 454-7871
Fax
(502) 454-7872
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 02245 KY Primary

Addresses

Primary practice location

2934 Breckenridge LN Ste 2
Louisville, KY 40220-3903

Mailing address

2934 Breckenridge LN Ste 2
Louisville, KY 40220-3903
Phone (502) 454-7871

Other identifiers 1

IdentifierTypeStateIssuer
64022452MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080606000039 KY Practitioner - Neurology 1759451487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Philadelphia College of Osteopathic Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2934 Breckenridge LN
Suite 2
Louisville, KY 40220-3903
Phone (502) 454-7871

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Alt DO PSC Neurology CurrentSince Jun 1, 2008 Accepting new patients
St Matthews Neurology PSC Neurology Past Accepting new patients
Neurohealth Consultants, PLLC Neurology Past Accepting new patients

Locations

2934 Breckenridge Ln
Ste 2
Louisville, KY 40220
Phone (502) 454-7871

4002 Kresge Way
Ste 124
Louisville, KY 40207
Phone (502) 895-4263

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397692800000",
    "number": "1740227255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2934 BRECKENRIDGE LN STE 2",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402203903",
            "telephone_number": "502-454-7871",
            "fax_number": "502-454-7872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2934 BRECKENRIDGE LN STE 2",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402203903",
            "telephone_number": "502-454-7871",
            "fax_number": "502-454-7872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALT",
        "first_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2014-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KY",
            "license": "02245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64022452",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.