NPIMap

Individual provider Active NPI

Steven Faddis, PA

  • Physician Assistant
  • Louisville, KY
National Provider Identifier
1821691627
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3 Audubon Plaza Dr Ste 560
Louisville, KY 40217-1376
Phone
(502) 634-3805
Fax
(502) 634-9336
NPI assigned
Nov 16, 2020
Last updated
Apr 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3 Audubon Plaza Dr Ste 560
Louisville, KY 40217-1376

Mailing address

PO Box 776351 Pob I Suite 202
Chicago, IL 60677-6351
Phone (502) 588-9490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, KY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211021000135 TX Practitioner - Physician Assistant 6406244649 Reassigns benefits to 1 organization
I20230203002137 KY Practitioner - Physician Assistant 6406244649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

1 Audubon Plaza Dr
Louisville, KY 40217-1318
Phone (502) 636-7225

200 E Chestnut St
Louisville, KY 40202-1831
Phone (502) 893-1270

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Physician Assistant CurrentSince Feb 1, 2023 Accepting new patients
Community Medical Associates, Inc. CurrentSince Feb 1, 2023 Accepting new patients
Medhealth CurrentSince Oct 11, 2021 Accepting new patients
Advanced Pain & Rehabilitation Association PLLC Past Accepting new patients
Community Medical Associates, Inc. Physician Assistant Past Accepting new patients

Locations

3 Audubon Plaza Dr
Ste 560
Louisville, KY 40217
Phone (502) 636-8004

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

150 Frankfort Rd
Ste 102C
Shelbyville, KY 40065
Phone (502) 882-8414

3430 W Wheatland Rd
Ste 202
Dallas, TX 75237
Phone (972) 283-1800

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

613 S Highway 78
Wylie, TX 75098
Phone (972) 941-8700

Interoperability endpoints

  • Direct secure messaging: sfaddis249427@direct.nortonhealthcare.org

Organizations & group practices 5

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1821691627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351 POB I SUITE 202",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 AUDUBON PLAZA DR STE 560",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171376",
            "telephone_number": "502-634-3805",
            "fax_number": "502-634-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADDIS",
        "first_name": "STEVEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-16",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.