NPIMap

Individual provider Active NPI

Mark A Severtson, M.D.

  • Otolaryngology Physician
  • Louisville, KY
National Provider Identifier
1861499576
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
34466 Issued in KY
Practice address
6420 Dutchmans Pkwy
380
Louisville, KY 40205-3372
Phone
(502) 894-8441
Fax
(502) 894-4453
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 34466 KY Primary
Otolaryngology Physician 207Y00000X 01049174 IN
Otology & Neurotology Physician 207YX0901X 01049174 IN
Otology & Neurotology Physician 207YX0901X 34466 KY

Addresses

Primary practice location

6420 Dutchmans Pkwy
380
Louisville, KY 40205-3372

Mailing address

401 E Chestnut St Unit 170
Louisville, KY 40202-5701
Phone (502) 583-3687

Other identifiers 4

IdentifierTypeStateIssuer
000000045447OtherKYANTHEM FACET NUMBER
040012436OtherKYRAIL ROAD MEDICARE
64344666MedicaidKY
200175990AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, 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
I20091229000537 IN Practitioner - Otolaryngology 5395884464 Reassigns benefits to 1 organization
I20100224000738 KY Practitioner - Otolaryngology 5395884464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Columbia University College of Physicians and Surgeons, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

401 E Chestnut St
Louisville, KY 40202-5700
Phone (502) 813-6410

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Oct 15, 2025 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Oct 15, 2025 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

1263 Hospital Dr NW
Ste 100
Corydon, IN 47112
Phone (502) 888-1988

401 E Chestnut St
Louisville, KY 40202
Phone (502) 588-4400

401 E Chestnut St
Unit 170
Louisville, KY 40202
Phone (502) 588-4271

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

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 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1861499576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E CHESTNUT ST UNIT 170",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402025701",
            "telephone_number": "502-583-3687",
            "fax_number": "502-588-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 DUTCHMANS PKWY",
            "address_2": "380",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402053372",
            "telephone_number": "502-894-8441",
            "fax_number": "502-894-4453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERTSON",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "KY",
            "license": "34466",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01049174",
            "primary": false
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "IN",
            "license": "01049174",
            "primary": false
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "KY",
            "license": "34466",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM FACET NUMBER",
            "identifier": "000000045447",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "040012436",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64344666",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200175990A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.