Individual provider Active NPI

Gloria Maldonado, PA-C

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1881278224
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2842 Issued in KY
Practice address
740 S Limestone
Ste L504
Lexington, KY 40536
Phone
(859) 323-5544
Fax
(859) 257-9288
NPI assigned
May 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TC068 KY
Medical Physician Assistant 363AM0700X TC068 KY
Medical Physician Assistant 363AM0700X PA2875 KY
Surgical Physician Assistant 363AS0400X TC068 KY
Surgical Physician Assistant 363AS0400X PA2875 KY
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA2842 KY Primary

Addresses

Primary practice location

740 S Limestone
Ste L504
Lexington, KY 40536

Mailing address

740 S Limestone
Lexington, KY 40536-0001

Other practice location 1

740 S Limestone
Lexington, KY 40536-0001
Phone (859) 323-5544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210903001283 KY Practitioner - Physician Assistant 4688070378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.76 of 100Reported as group
Quality
78.19
Promoting interoperability
100
Improvement activities
40
Cost
70.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2842KYMDMedical Physician Assistant
PA2875KYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky CurrentSince Aug 2, 2021 Accepting new patients
University of Kentucky Past Accepting new patients

Locations

3101 Beaumont Centre Cir
Ste 100
Lexington, KY 40513
Phone (859) 323-5544

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

Interoperability endpoints

  • Direct secure messaging: gmaldonado130361@ukhcdirect.org

Organizations & group practices 2

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": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1881278224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE",
            "address_2": "STE L504",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40536",
            "telephone_number": "859-323-5544",
            "fax_number": "859-257-9288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "740 S Limestone",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360001",
            "country_code": "US",
            "telephone_number": "859-323-5544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "GLORIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC068",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "TC068",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA2875",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "TC068",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "PA2875",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.