Individual provider Active NPI

Mae Dinn

  • Physician Assistant
  • Florence, KY
National Provider Identifier
1902227366
Registry record updated Jan 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1830 Issued in KY
Practice address
7766 Ewing Blvd
Ste 100
Florence, KY 41042-7537
Phone
(859) 283-1033
Fax
(859) 283-1066
NPI assigned
Jan 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1830 KY Primary

Addresses

Primary practice location

7766 Ewing Blvd
Ste 100
Florence, KY 41042-7537

Mailing address

7766 Ewing Blvd
Ste 100
Florence, KY 41042-7537
Phone (859) 283-1033

Other identifiers 1

IdentifierTypeStateIssuer
PA1830OtherKYKENTUCKY BOARD OF MEDICAL LICENSURE

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
I20200130000711 KY Practitioner - Physician Assistant 4981030509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates of Northern Kentucky PSCGroup PAC ID 1153304647, 11 clinicians

Practice addresses (Care Compare)

7766 Ewing Blvd
Suite 100
Florence, KY 41042-7537
Phone 8592861033240

Hospital & facility affiliations

  • St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035

Merit-based Incentive Payment System (MIPS)

Final score
88.38 of 100Reported as group
Quality
83.58
Promoting interoperability
86
Improvement activities
40
Cost
89.35

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Proven Cosmetic Dermatology PastSince Aug 28, 2021 Accepting new patients

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388620800000",
    "number": "1902227366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7766 EWING BLVD",
            "address_2": "STE 100",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410427537",
            "telephone_number": "859-283-1033",
            "fax_number": "859-283-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7766 EWING BLVD",
            "address_2": "STE 100",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410427537",
            "telephone_number": "859-283-1033",
            "fax_number": "859-283-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINN",
        "first_name": "MAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-02",
        "last_updated": "2014-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY BOARD OF MEDICAL LICENSURE",
            "identifier": "PA1830",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, KY

Sources for this page

Verify at the official NPI Registry.