Individual provider Active NPI

Juan Luis Quintero, M.D.

  • Plastic Surgery Physician
  • Louisville, KY
National Provider Identifier
1831397066
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
39660 Issued in KY
Practice address
2341 Lime Kiln LN
Louisville, KY 40222-3460
Phone
(502) 899-9979
NPI assigned
Jul 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 39660 KY Primary

Addresses

Primary practice location

2341 Lime Kiln LN
Louisville, KY 40222-3460

Mailing address

217 Breckenridge LN
Louisville, KY 40207-3858
Phone (502) 895-1900

Other practice location 1

217 Breckenridge Ln
Louisville, KY 40207-3858
Phone (502) 895-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39660KYMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
C & M Medical Services, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1831397066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 BRECKENRIDGE LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073858",
            "telephone_number": "502-895-1900",
            "fax_number": "502-893-2937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2341 LIME KILN LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402223460",
            "telephone_number": "502-899-9979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 Breckenridge Ln",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402073858",
            "country_code": "US",
            "telephone_number": "502-895-1900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUINTERO",
        "first_name": "JUAN",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "KY",
            "license": "39660",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.