Individual provider Active NPI

Carmen Tania Condurache, M.D.

  • Pediatrics Physician
  • Louisville, KY
National Provider Identifier
1992834873
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
41028 Issued in KY
Practice address
231 E Chestnut St
Louisville, KY 40202-1821
Phone
(502) 629-6000
Fax
(502) 629-4617
NPI assigned
Mar 5, 2007
Last updated
May 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 41028 KY Primary

Addresses

Primary practice location

231 E Chestnut St
Louisville, KY 40202-1821

Mailing address

4803 Olympia Park PLZ Ste 1100
Louisville, KY 40241-3068
Phone (502) 559-9295

Other identifiers 2

IdentifierTypeStateIssuer
200900580MedicaidIN
7100035480MedicaidKY

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address ccondurache39996@direct.nortonhealthcare.org Direct
Direct Messaging Address ccondurache39996@direct.nortonhealthcare.org
FHIR URL https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/

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
I20080320000575 KY Practitioner - Pediatric Medicine 2567548282 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41028KYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Sep 1, 2012 Accepting new patients
Norton Children's Medical Group, LLC Pediatrics CurrentSince Mar 1, 2020 Accepting new patients
University of Louisville Physicians, Inc. Pediatrics CurrentSince Sep 1, 2012 Accepting new patients
Norton Children's Medical Group, LLC Current Accepting new patients
Norton Children's Medical Group, LLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

1930 Bishop Ln
Ste 1017
Louisville, KY 40218
Phone (502) 272-5064

231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500

4803 Olympia Park Plz
Ste 1100
Louisville, KY 40241
Phone (502) 272-5134

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

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1992834873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4803 OLYMPIA PARK PLZ STE 1100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402413068",
            "telephone_number": "502-559-9295",
            "fax_number": "502-272-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 E CHESTNUT ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021821",
            "telephone_number": "502-629-6000",
            "fax_number": "502-629-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDURACHE",
        "first_name": "CARMEN",
        "middle_name": "TANIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "41028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200900580",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100035480",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccondurache39996@direct.nortonhealthcare.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "231 E Chestnut St",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021821",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccondurache39996@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "231 E Chestnut St",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021821",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "231 E Chestnut St",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.