NPIMap

Organization Active NPI

Amin's Family Practice Associates , PSC

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1750307393
Registry record updated May 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
AMIN'S FAMILY PRACTICE ASSOCIATES , PSC
Practice address
1505 S 7TH St
Louisville, KY 40208-1710
Phone
(502) 637-1005
Fax
(502) 635-0046
NPI assigned
Jul 15, 2006
Last updated
May 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2014

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

Authorized official

Name
Rajan R Amin, M.D.
Title
President
Phone
(502) 637-1005

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X NU
Family Nurse Practitioner 363LF0000X NU Primary
Family Medicine Physician 207Q00000X 19340 KY
General Practice Physician 208D00000X NU

Addresses

Primary practice location

1505 S 7TH St
Louisville, KY 40208-1710

Mailing address

1505 S 7TH St
Louisville, KY 40208-1710
Phone (502) 637-1005

Other identifiers 7

IdentifierTypeStateIssuer
2432747001OtherKYPASSPORT ADVANTAGE
1050007OtherKYPASSPORT HEALTH PLAN
2432748001OtherKYPASSPORT ADVANTAGE
65911745MedicaidKY
1050006OtherKYPASSPORT HEALTH PLAN
2432749001OtherKYPASSPORT ADVANTAGE
1050005OtherKYPASSPORT HEALTH PLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040216000969 KY Part B Supplier - Clinic/Group Practice 7416842844 Receives reassigned benefits from 37 practitioners
Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398988800000",
    "number": "1750307393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 S 7TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402081710",
            "telephone_number": "502-637-1005",
            "fax_number": "502-635-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 S 7TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402081710",
            "telephone_number": "502-637-1005",
            "fax_number": "502-635-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMIN'S FAMILY PRACTICE ASSOCIATES , PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2014-05-02",
        "status": "A",
        "authorized_official_last_name": "AMIN",
        "authorized_official_first_name": "RAJAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-637-1005",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "19340",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2432747001",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLAN",
            "identifier": "1050007",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2432748001",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65911745",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLAN",
            "identifier": "1050006",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2432749001",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLAN",
            "identifier": "1050005",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.