NPIMap

Individual provider Active NPI

Michael Eli Pendleton, MD

  • Family Medicine Physician
  • Louisville, KY
National Provider Identifier
1922211556
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
43483 Issued in KY
Practice address
215 Central Ave Ste 100
Louisville, KY 40208
Phone
(502) 588-8720
Fax
(502) 588-8721
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 43483 KY Primary

Addresses

Primary practice location

215 Central Ave Ste 100
Louisville, KY 40208

Mailing address

5200 Commerce Crossings Dr FL 3
Louisville, KY 40229-2182
Phone (502) 253-4924

Other practice location 1

1603 Stevens Ave
Louisville, KY 40205
Phone (502) 451-5955

Other identifiers 5

IdentifierTypeStateIssuer
50029699OtherKYPASSPORT HEALTH PLAN
50029700OtherKYPASSPORT HEALTH PLAN
50029698OtherKYPASSPORT HEALTH PLAN
7100127990MedicaidKY
50029701OtherKYPASSPORT HEALTH PLAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpendleton21160@bhkydirect.com

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
I20100929001146 KY Practitioner - Family Practice 7214009190 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kentucky College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

1603 Stevens Ave
Louisville, KY 40205-1087
Phone (502) 753-0638

3900 Kresge Way
Louisville, KY 40207-4681

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43483KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians Inc. CurrentSince Dec 3, 2011 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Nov 1, 2019 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Dec 3, 2011 Accepting new patients
University of Louisville Physicians, Inc. Family Medicine Current Accepting new patients
Baptist Health Medical Group Inc CurrentSince Nov 1, 2019 Accepting new patients
Piedmont Emergency Consultants, PLC Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

1010 Neighborhood Pl
Fairdale, KY 40118
Phone (502) 482-8946

215 Central Ave
Ste 102
Louisville, KY 40208
Phone (502) 588-8720

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

1603 Stevens Ave
Louisville, KY 40205
Phone (502) 451-5955

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

1941 Bishop Ln
Ste 900
Louisville, KY 40218
Phone (502) 588-2500

2700 Stanley Gault Pkwy
Ste 129
Louisville, KY 40223
Phone (502) 253-4900

215 Central Ave
Ste 100
Louisville, KY 40208
Phone (502) 588-8720

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

215 Central Ave
Ste 205
Louisville, KY 40208
Phone (502) 588-8700

550 S Jackson St
Fl 1
Louisville, KY 40202
Phone (502) 552-6503

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

401 E Chestnut St
Unit 610
Louisville, KY 40202
Phone (502) 588-4450

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1922211556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 COMMERCE CROSSINGS DR FL 3",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402292182",
            "telephone_number": "502-253-4924",
            "fax_number": "502-489-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 CENTRAL AVE STE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40208",
            "telephone_number": "502-588-8720",
            "fax_number": "502-588-8721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1603 Stevens Ave",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "40205",
            "country_code": "US",
            "telephone_number": "502-451-5955",
            "fax_number": "502-451-5925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENDLETON",
        "first_name": "MICHAEL",
        "middle_name": "ELI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "43483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLAN",
            "identifier": "50029699",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLAN",
            "identifier": "50029700",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLAN",
            "identifier": "50029698",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100127990",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLAN",
            "identifier": "50029701",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpendleton21160@bhkydirect.com",
            "affiliation": "N",
            "address_1": "1603 Stevens Ave",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "40205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.