NPIMap

Individual provider Active NPI

Mohammad Fahmi Mathbout, MBBS

  • Interventional Cardiology Physician
  • Louisville, KY
National Provider Identifier
1912389826
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
51527 Issued in KY
Practice address
210 E Gray St Ste 1002
Louisville, KY 40202-3906
Phone
(502) 584-2029
Fax
(502) 584-0873
NPI assigned
Jun 27, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 01087867A IN
Hospitalist Physician 208M00000X 51527 KY
Student in an Organized Health Care Education/Training Program 390200000X 51527 KY
Interventional Cardiology Physician 207RI0011X 51527 KY Primary

Addresses

Primary practice location

210 E Gray St Ste 1002
Louisville, KY 40202-3906

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other practice location 1

913 N Dixie Ave
Elizabethtown, KY 42701-2503
Phone (507) 226-1482

Other practice location 2

900 S Limestone Ctw 304
Lexington, KY 40536-0293
Phone (859) 323-9918

Other practice location 3

201 Abraham Flexner Way Ste 600
Louisville, KY 40202-3841
Phone (507) 226-1482

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmathbout238600@direct.nortonhealthcare.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 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
I20190104002671 KY Practitioner - Internal MedicinePractitioner - Hospitalist 9537405923 Reassigns benefits to 2 organizations
I20220720002092 IN Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 9537405923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, shared by 2 NPIs, 1,368 clinicians

Practice addresses (Care Compare)

1263 Hospital Dr NW
Suite 210
Corydon, IN 47112-2177
Phone (502) 899-6150

210 E Gray St
Suite 1002
Louisville, KY 40202-3906
Phone (502) 584-2029

Hospital & facility affiliations

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting37
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01087867AINMDInterventional Cardiology Physician
51527KYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
KND Development 59 LLC Hospitalist CurrentSince Jun 3, 2021 Accepting new patients
KND Development 59, LLC Hospitalist CurrentSince Jun 3, 2021 Accepting new patients
Community Medical Associates, Inc. Interventional Cardiology CurrentSince Aug 1, 2022 Accepting new patients
Community Medical Associates, Inc. CurrentSince Aug 1, 2022 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Uk Healthcare Past Accepting new patients
Community Medical Associates, Inc. Past Accepting new patients

Locations (25 of 31)

25 W Main St
Austin, IN 47102
Phone (812) 252-9020

2051 Clevidence Blvd
Clarksville, IN 47129
Phone (812) 280-6650

1263 Hospital Dr NW
Ste 210
Corydon, IN 47112
Phone (502) 636-7242

207 Sparks Ave
Ste 101
Jeffersonville, IN 47130
Phone (812) 280-7063

207 Sparks Ave
Ste 100
Jeffersonvlle, IN 47130
Phone (812) 284-4357

630 Broadway St
Ste 1A
Madison, IN 47250
Phone (502) 629-2935

1373 E State Road 62
#6F
Madison, IN 47250
Phone (502) 629-7181

1467 N Gardner St
Scottsburg, IN 47170

1473 N Gardner St
Scottsburg, IN 47170
Phone (812) 752-0844

309 11th St
Carrollton, KY 41008
Phone (502) 732-3241

2410 Ring Rd
Ste 500
Elizabethtown, KY 42701
Phone (270) 765-5900

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

279 Kings Daughters Dr
Ste 204
Frankfort, KY 40601
Phone (502) 875-9885

207 Fairgrounds Rd
Hardinsburg, KY 40143
Phone (270) 580-2256

312 W High St
Lebanon, KY 40033
Phone (270) 692-0110

325 W Walnut St
Lebanon, KY 40033
Phone (270) 699-9500

912 Wallace Ave
Ste 104
Leitchfield, KY 42754
Phone (270) 287-0001

1313 Saint Anthony Pl
Louisville, KY 40204
Phone (502) 587-7001

3999 Dutchmans Ln
Ste 1H
Louisville, KY 40207
Phone (502) 636-7472

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

4123 Dutchmans Ln
Ste 301
Louisville, KY 40207
Phone (502) 896-2500

170 Dr Arla Way
Ste 101
Louisville, KY 40229
Phone (502) 888-1988

2355 Poplar Level Rd
Ste 200
Louisville, KY 40217
Phone (502) 365-2655

4420 Dixie Hwy
Ste 118
Louisville, KY 40216
Phone (502) 447-3448

6420 Dutchmans Pkwy
Ste 200
Louisville, KY 40205
Phone (502) 891-8333

Organizations & group practices 8

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1435363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1912389826",
    "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",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E GRAY ST STE 1002",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023906",
            "telephone_number": "502-584-2029",
            "fax_number": "502-584-0873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "913 N Dixie Ave",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "KY",
            "postal_code": "427012503",
            "country_code": "US",
            "telephone_number": "507-226-1482",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 S Limestone Ctw 304",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360293",
            "country_code": "US",
            "telephone_number": "859-323-9918",
            "fax_number": "859-323-1197",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 Abraham Flexner Way Ste 600",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402023841",
            "country_code": "US",
            "telephone_number": "507-226-1482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHBOUT",
        "first_name": "MOHAMMAD",
        "middle_name": "FAHMI",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-27",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IN",
            "license": "01087867A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KY",
            "license": "51527",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KY",
            "license": "51527",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "KY",
            "license": "51527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmathbout238600@direct.nortonhealthcare.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "210 E Gray St Ste 1002",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402023906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.