Individual provider Active NPI

Vincent Prusick, M.D.

  • Pediatric Orthopaedic Surgery Physician
  • Lexington, KY
National Provider Identifier
1902164411
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
51561 Issued in KY
Practice address
110 Conn Ter
Lexington, KY 40508
Phone
(586) 268-5741
NPI assigned
May 3, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Orthopaedic Surgery Physician 207XP3100X 56224 TN
Pediatric Orthopaedic Surgery Physician 207XP3100X 51561 KY Primary

Addresses

Primary practice location

110 Conn Ter
Lexington, KY 40508

Mailing address

110 Conn Ter
Lexington, KY 40508-3206
Phone (859) 268-5622

Other practice location 1

University Of Kentucky
800 Rose Street HQ101
Lexington, KY 40536-0001
Phone (859) 218-3044

Other practice location 2

2200 Childrens Way
Nashville, TN 37232
Phone (615) 875-6184

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180920002222 KY Practitioner - Orthopedic Surgery 6901124379 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
68.25
Promoting interoperability
100
Improvement activities
40
Cost
72.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51561KYMDPediatric Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children Current Accepting new patients
Kentucky Medical Services Foundation, Inc CurrentSince Aug 10, 2018 Accepting new patients
Shriners Hospitals for Children CurrentSince Oct 11, 2022 Accepting new patients
Shriners Hospitals for Children CurrentSince Oct 11, 2022 Accepting new patients
University of Kentucky Past Accepting new patients
Commission for Children With Special Health Car Past Accepting new patients
Shriners Hospitals for Children Past Accepting new patients

Locations

800 Rose St
#101
Lexington, KY 40536
Phone (859) 323-5871

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

215 Radio Dr
Ste 100
Woodbury, MN 55125
Phone (612) 596-6100

Interoperability endpoints

  • Direct secure messaging: vprusick17982@ukhcdirect.org

Organizations & group practices 7

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": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1902164411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CONN TER",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405083206",
            "telephone_number": "859-268-5622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CONN TER",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40508",
            "telephone_number": "586-268-5741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "University Of Kentucky",
            "address_2": "800 Rose Street HQ101",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360001",
            "country_code": "US",
            "telephone_number": "859-218-3044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "37232",
            "country_code": "US",
            "telephone_number": "615-875-6184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUSICK",
        "first_name": "VINCENT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "TN",
            "license": "56224",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "KY",
            "license": "51561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.