NPIMap

Individual provider Active NPI

Ivan Pena, MD

  • Interventional Cardiology Physician
  • Louisville, KY
National Provider Identifier
1770978587
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
TP957 Issued in KY
Practice address
3900 Kresge Way Ste 60
Louisville, KY 40207-4690
Phone
(502) 893-7710
Fax
(502) 893-1391
NPI assigned
Mar 30, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Interventional Cardiology Physician 207RI0011X TP957 KY Primary

Addresses

Primary practice location

3900 Kresge Way Ste 60
Louisville, KY 40207-4690

Mailing address

3900 Kresge Wat
Suite 60
Louisville, KY 40207
Phone (502) 893-7710

Other practice location 1

2150 Pennsylvania Ave NW
The GW Medical Faculty Associates
Washington, DC 20037-3201
Phone (202) 741-3000

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
I20220725002494 KY Practitioner - Interventional Cardiology 4981903580 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Rutgers New Jersey Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

200 Cardinal Dr
Suite 308
Elizabethtown, KY 42701-2787
Phone (270) 765-5921

Hospital & facility affiliations

  • Baptist Health Louisville Hospital, Louisville, KY, CCN 180130
  • Baptist Health Lagrange Hospital, La Grange, KY, CCN 180138
  • Baptist Health Hardin Hospital, Elizabethtown, KY, CCN 180012
  • UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Hospital, Louisville, KY, CCN 180040
  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting85
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Medical Associates Inc CurrentSince Jul 8, 2022 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jul 8, 2022 Accepting new patients
Baptist Health Medical Group Inc Past Accepting new patients

Locations

200 Cardinal Dr
Ste 308
Elizabethtown, KY 42701

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

3900 Kresge Way
Ste 60
Louisville, KY 40207
Phone (502) 893-7710

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

Organizations & group practices 4

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.

Hospital & facility affiliations 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1770978587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 KRESGE WAT",
            "address_2": "SUITE 60",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40207",
            "telephone_number": "502-893-7710",
            "fax_number": "502-893-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 KRESGE WAY STE 60",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074690",
            "telephone_number": "502-893-7710",
            "fax_number": "502-893-1391"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2150 Pennsylvania Ave NW",
            "address_2": "The GW Medical Faculty Associates",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200373201",
            "country_code": "US",
            "telephone_number": "202-741-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENA",
        "first_name": "IVAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-30",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "KY",
            "license": "TP957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.