NPIMap

Individual provider Active NPI

Maureen Carberry, PA

  • Physician Assistant
  • Louisville, KY
National Provider Identifier
1861945693
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3183 Issued in KY
Practice address
3999 Dutchmans LN Ste 2E
Louisville, KY 40207-4748
Phone
(502) 559-6560
NPI assigned
Jul 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 50.006551RX OH
Physician Assistant 363A00000X PA3183 KY Primary

Addresses

Primary practice location

3999 Dutchmans LN Ste 2E
Louisville, KY 40207-4748

Mailing address

PO Box 776351
Chicago, IL 60677-6351

Other practice location 1

111 S Grant Ave Ste 350
Columbus, OH 43215-4701
Phone (614) 566-9550

Other practice location 2

11850 Blackfoot St NW
#300
Coon Rapids, MN 55433-2578
Phone (763) 236-9000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcarberry508504@direct.ohiohealth.com OhioHealth Physician Group

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
I20231108000813 KY Practitioner - Physician Assistant 2567740855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
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)

3999 Dutchmans LN
Suite 2E
Louisville, KY 40207-4748
Phone (502) 559-6560

4001 Dutchmans LN
Louisville, KY 40207-4714
Phone (502) 893-1270

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

Hospital & facility affiliations

  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2579MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates CurrentSince Nov 1, 2023 Accepting new patients
Community Medical Associates, Inc. CurrentSince Nov 1, 2023 Accepting new patients
Community Medical Associates, Inc. Physician Assistant Past Accepting new patients

Locations

9880 Angies Way
Ste 110
Louisville, KY 40241
Phone (502) 371-9700

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

3999 Dutchmans Ln
Ste 2E
Louisville, KY 40207
Phone (502) 559-6560

Interoperability endpoints

  • Direct secure messaging: mcarberry277766@direct.nortonhealthcare.org

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 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": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1861945693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3999 DUTCHMANS LN STE 2E",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074748",
            "telephone_number": "502-559-6560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 S Grant Ave Ste 350",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432154701",
            "country_code": "US",
            "telephone_number": "614-566-9550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11850 Blackfoot St NW",
            "address_2": "#300",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554332578",
            "country_code": "US",
            "telephone_number": "763-236-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARBERRY",
        "first_name": "MAUREEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-28",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006551RX",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA3183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcarberry508504@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "111 S Grant Ave",
            "address_2": "Ste 350",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432154701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.