| Hospital Internal Medicine Associates, Pllc | |
|
200 Abraham Flexner Way Louisville KY 40202-2877 | |
| (812) 948-5120 | |
| Not Available |
| Full Name | Hospital Internal Medicine Associates, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 200 Abraham Flexner Way, Louisville, Kentucky |
| Authorized Official Name and Position | Ahmad N Nasraty (OWNER) |
| Authorized Official Contact | 8129485120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hospital Internal Medicine Associates, Pllc 5001 Spring Farm Rd Prospect KY 40059-9654 Ph: (502) 584-4479 | Hospital Internal Medicine Associates, Pllc 200 Abraham Flexner Way Louisville KY 40202-2877 Ph: (812) 948-5120 |
| NPI Number | 1962423285 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 01/08/2019 |
| Medicare PECOS PAC ID | 2769372333 |
|---|---|
| Medicare Enrollment ID | O20040317001041 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962423285 | NPI | - | NPPES |
| 1106141 | Other | KY | PASSPORT |
| 65932881 | Medicaid | KY | |
| 2436477000 | Other | KY | PASSPORT ADVANTAGE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Tina N Bradley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144223082 PECOS PAC ID: 5496735615 Enrollment ID: I20040720001127 |
| Provider Name | Ranjhan K Gopang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720051865 PECOS PAC ID: 6901837533 Enrollment ID: I20050824000149 |
| Provider Name | Keith B Carter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134111792 PECOS PAC ID: 2365634326 Enrollment ID: I20101215000938 |
| Provider Name | Kelli A Rogerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750688412 PECOS PAC ID: 6608050570 Enrollment ID: I20110419000013 |
| Provider Name | Ahmed Naweed Nasraty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588637623 PECOS PAC ID: 6709776388 Enrollment ID: I20120705000032 |
| Provider Name | Rayshunale Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639420276 PECOS PAC ID: 8022260520 Enrollment ID: I20121207000430 |
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