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9517 Us Highway 42 Prospect KY 40059-9237 | |
| (502) 587-0521 | |
| (502) 587-3901 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 9517 Us Highway 42, Prospect, Kentucky |
| Authorized Official Name and Position | Salvatore Ciliberti (VICE PRESIDENT) |
| Authorized Official Contact | 5025870521 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
9517 Us Highway 42 Prospect KY 40059-9237 Ph: (502) 587-0521 | 9517 Us Highway 42 Prospect KY 40059-9237 Ph: (502) 587-0521 |
| NPI Number | 1407820533 |
|---|---|
| Provider Enumeration Date | 02/15/2006 |
| Last Update Date | 11/30/2021 |
| Medicare PECOS PAC ID | 9032191143 |
|---|---|
| Medicare Enrollment ID | O20040602001640 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407820533 | NPI | - | NPPES |
| 65901316 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael D Chesnut |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821127333 PECOS PAC ID: 9638266067 Enrollment ID: I20071101000655 |
| Provider Name | Salvatore Anthony Ciliberti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770506073 PECOS PAC ID: 4688761018 Enrollment ID: I20100609000534 |
| Provider Name | James William Bosler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932173887 PECOS PAC ID: 8224125653 Enrollment ID: I20100715000936 |
| Provider Name | Jennifer Lynn Walden-fain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841211174 PECOS PAC ID: 0941397376 Enrollment ID: I20100715001032 |
| Provider Name | Gregory John Ciliberti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285657585 PECOS PAC ID: 6406943836 Enrollment ID: I20100715001041 |
| Provider Name | Harry L Renco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124093075 PECOS PAC ID: 2062544703 Enrollment ID: I20100715001051 |
| Provider Name | Jeffrey Thomas Omer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821062605 PECOS PAC ID: 4587751912 Enrollment ID: I20100715001058 |
| Provider Name | Padmapriya Balakrishna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295709251 PECOS PAC ID: 0143317578 Enrollment ID: I20100720000143 |
Advanced Medical Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13003 Tattersall Ln, Prospect, KY 40059 Phone: 502-345-1109 | |
Town Family Doctor, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9501 Norton Commons Blvd, Unit B, Prospect, KY 40059 Phone: 502-618-2472 Fax: 502-618-2479 | |
Internal Medicine And Pediatric Partners, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6341 Meeting St Ste 102, Prospect, KY 40059 Phone: 502-566-0300 | |
Egan Clinic Psc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12945 W Highway 42, Prospect, KY 40059 Phone: 502-228-7530 Fax: 502-228-7533 |