Tehmina Ali, PA-C
Individual provider Active NPI Physician Assistant · Elizabethtown, KY
NPI 1760997183 · NPPES record last updated Jul 6, 2023
Key facts
- NPI
- 1760997183
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA2247 (KY)
- Practice address
- 2333 Ring Rd
Elizabethtown, KY 42701-9162 - Phone
- (270) 737-4503
- Fax
- (270) 737-4503
- NPI assigned
- Dec 7, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Forefront Dermatology SC
Practice addresses (Care Compare)
2333 Ring Rd
Elizabethtown, KY 42701-9162
Phone (270) 737-4503
321 E Broadway St
Suite 101
Campbellsville, KY 42718-2003
Phone (270) 737-4503
501 S 2ND St
Louisville, KY 40202-2862
Phone (502) 583-7546
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.45 of 100
- Promoting interoperability
- 97
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180222003079 | KY | Practitioner - Physician Assistant | 5092076638 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA2247 | KY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Forefront Dermatology, S.C. | Current |
Accepting new patients | |
| Forefront Dermatology, S.C. | Current |
Accepting new patients | |
| Forefront Dermatology, S.C. | Past | Accepting new patients |
Locations
321 E Broadway St
#101
Campbellsville, KY 42718
Phone (270) 737-4503
2333 Ring Rd
Elizabethtown, KY 42701
Phone (270) 737-4503
501 S 2nd St
Louisville, KY 40202
Phone (502) 583-7546
801 York St
Manitowoc, WI 54220
Phone (866) 630-9882
Interoperability endpoints
- tehmina.ali@forefrontdermatology.emadirect.md
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA2247 | KY | Yes |
Addresses
Primary practice location
2333 Ring Rd
Elizabethtown, KY 42701-9162
Mailing address
801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008
Other practice location 1
321 E Broadway St
Ste 101
Campbellsville, KY 42718-2003
Phone (270) 737-4503
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Tehmina.Ali@forefrontdermatology.emadirect.md | ||
| Direct Messaging Address | Tehmina.Ali@forefrontdermatology.emadirect.md |
Other providers in Elizabethtown, KY
- Rebecca Aldridge
- Cory Lee Alexander
- Taylor Alexander
- Roberto E Alfaro-Saprissa
- Ali Counseling Group Services Inc
- Teresa Allara
- Brandon Jarrett Allen
- Joan Lee Allen
- Olivia Allen
- Roger K Allen
All providers in Elizabethtown, KY · Physician Assistant in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.