Hazelwood Specialty Clinic - Medicare Primary Care in Louisville, KY

Hazelwood Specialty Clinic is a medicare enrolled primary clinic (Clinic/center - Multi-specialty) in Louisville, Kentucky. The current practice location for Hazelwood Specialty Clinic is 1800 Bluegrass Ave, Louisville, Kentucky. For appointments, you can reach them via phone at (502) 361-2301. The mailing address for Hazelwood Specialty Clinic is 1800 Bluegrass Ave, Louisville, Kentucky and phone number is (502) 361-2301.

Hazelwood Specialty Clinic is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1114346467. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (502) 361-2301.

Contact Information

Hazelwood Specialty Clinic
1800 Bluegrass Ave
Louisville
KY 40215-1130
(502) 361-2301
(502) 366-0367

Map and Direction


Primary Care Clinic Profile

Full NameHazelwood Specialty Clinic
SpecialityClinic/Center
Location1800 Bluegrass Ave, Louisville, Kentucky
Authorized Official Name and PositionStephanie Craycraft (ACTING COMMISSIONER)
Authorized Official Contact5027826243
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Hazelwood Specialty Clinic
1800 Bluegrass Ave
Louisville
KY 40215-1130

Ph: (502) 361-2301
Hazelwood Specialty Clinic
1800 Bluegrass Ave
Louisville
KY 40215-1130

Ph: (502) 361-2301

NPI Details:

NPI Number1114346467
Provider Enumeration Date04/15/2014
Last Update Date04/26/2023

Medicare PECOS Information:

Medicare PECOS PAC ID0840180816
Medicare Enrollment IDO20040316000438

Medical Identifiers

Medical identifiers for Hazelwood Specialty Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114346467NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QM1300XClinic/center - Multi-specialty (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Hazelwood Specialty Clinic acts as a billing entity for following providers:
Provider NameRichard T Holt
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1669455630
PECOS PAC ID: 4880687813
Enrollment ID: I20040406000855
Provider NameToufic A Fakhoury
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1235234394
PECOS PAC ID: 4385653427
Enrollment ID: I20060418000333
Provider NameChristopher S Ross
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1851309140
PECOS PAC ID: 1557362787
Enrollment ID: I20070130000607
Provider NameMiriam E. Harris-shelton
Provider TypePractitioner - Qualified Audiologist
Provider IdentifiersNPI Number: 1255581104
PECOS PAC ID: 9739236381
Enrollment ID: I20090416000446
Provider NameElizabeth M Caudill
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1861426991
PECOS PAC ID: 3274710215
Enrollment ID: I20110531000628
Provider NameArun Kaithi
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1851578579
PECOS PAC ID: 6305005828
Enrollment ID: I20120301000905
Provider NameRoy Lukat
Provider TypePractitioner - Qualified Audiologist
Provider IdentifiersNPI Number: 1962697573
PECOS PAC ID: 8325292949
Enrollment ID: I20130207000350
Provider NameAshima K Gupta
Provider TypePractitioner - Ophthalmology
Provider IdentifiersNPI Number: 1073509592
PECOS PAC ID: 8921100066
Enrollment ID: I20131003000109
Provider NameTiffany R Mcintyre
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1205801875
PECOS PAC ID: 1658501994
Enrollment ID: I20140314001500
Provider NameSeema V Kulkarni
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1902229305
PECOS PAC ID: 6709018765
Enrollment ID: I20140407001527
Provider NameLen Coughlin
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1932515814
PECOS PAC ID: 4082933593
Enrollment ID: I20150505002362
Provider NameKary Susan Brown
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1902178452
PECOS PAC ID: 6901127794
Enrollment ID: I20150604002396
Provider NameSarah Elizabeth Cassol
Provider TypePractitioner - Oral Surgery
Provider IdentifiersNPI Number: 1649366097
PECOS PAC ID: 0244543064
Enrollment ID: I20150722003894
Provider NameElsa E Joseph
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1255724332
PECOS PAC ID: 5496069189
Enrollment ID: I20150810001156
Provider NameKimberly Spencer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1316323850
PECOS PAC ID: 5193032506
Enrollment ID: I20150917001581
Provider NameAllison Roe
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1629485388
PECOS PAC ID: 4082912811
Enrollment ID: I20160412001818
Provider NameModupe C. Adesola
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1184076770
PECOS PAC ID: 7618262403
Enrollment ID: I20160817003019
Provider NameAshley Hill
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1073062634
PECOS PAC ID: 7810267945
Enrollment ID: I20170724001774
Provider NameRobin May
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1588969695
PECOS PAC ID: 2163609397
Enrollment ID: I20170811001831
Provider NameCarolyne C Kimeli-mbaraka
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1861932253
PECOS PAC ID: 8224300942
Enrollment ID: I20170815004405
Provider NameLydia Clare Coughlin
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1316458987
PECOS PAC ID: 4385903319
Enrollment ID: I20180118002641
Provider NameHayley Russell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1366937260
PECOS PAC ID: 5092062695
Enrollment ID: I20180726002974
Provider NameAshley Nicole Newton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508358359
PECOS PAC ID: 2668724105
Enrollment ID: I20181010002112
Provider NameEarl Edward Ellis
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1013111459
PECOS PAC ID: 1557608866
Enrollment ID: I20190124001944
Provider NameSheila Marie Kemper
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1811252638
PECOS PAC ID: 1557671963
Enrollment ID: I20190307002108
Provider NameLydia Marie Coots
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1467928895
PECOS PAC ID: 0840629879
Enrollment ID: I20200326001771
Provider NameBrianna Flanigan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1891303319
PECOS PAC ID: 6406271717
Enrollment ID: I20200804001326
Provider NameDakota R Hangartner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396348470
PECOS PAC ID: 6901219310
Enrollment ID: I20210104000701

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.