NPIMap

Individual provider Active NPI

Michael Joseph Eldemire, MD

  • Family Medicine Physician
  • Louisville, KY
National Provider Identifier
1770548430
Registry record updated Sep 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
41336 Issued in KY
Practice address
8442 Dixie Hwy
Louisville, KY 40258-1140
Phone
(502) 638-4280
Fax
(502) 638-4281
NPI assigned
Apr 18, 2006
Last updated
Sep 9, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01053566A IN
Family Medicine Physician 207Q00000X 41336 KY Primary

Addresses

Primary practice location

8442 Dixie Hwy
Louisville, KY 40258-1140

Mailing address

2112 Douglass Blvd
Louisville, KY 40205-1902
Phone (502) 638-4280

Other identifiers 2

IdentifierTypeStateIssuer
7100037280MedicaidKY
200291520MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071004000591 KY Practitioner - Family Practice 4981799095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr. Nair Internal Medicine, PLLCGroup PAC ID 7517955081, 15 clinicians

Practice addresses (Care Compare)

8442 Dixie Hwy
Louisville, KY 40258-1140
Phone (502) 638-4280

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01053566AINMDFamily Medicine Physician
41336KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Nair Internal Medicine, PLLC CurrentSince Apr 1, 2012 Accepting new patients
Havens Medical Group LLC Family Medicine Current Accepting new patients
Edwin P Hendricks, Jr. DO Family Medicine Past Accepting new patients

Locations

207 Sparks Ave
Ste 200
Jeffersonvlle, IN 47130
Phone (812) 283-4441

8442 Dixie Hwy
Louisville, KY 40258
Phone (502) 286-4644

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 22

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378684800000",
    "number": "1770548430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 DOUGLASS BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402051902",
            "telephone_number": "502-638-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8442 DIXIE HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402581140",
            "telephone_number": "502-638-4280",
            "fax_number": "502-638-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDEMIRE",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2013-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01053566A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "41336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100037280",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200291520",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.