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MRS. MARY LEE PANTESS NP
NPI 1043996911
Nurse Practitioner - Family in Louisville, KY

Active since June 26, 2023PECOS Enrolled
924 E BROADWAY, LOUISVILLE, KY 40204(502) 200-1335(502) 200-8904 Get Directions Write a Review

NPPES record last updated: July 27, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 27, 2026, Jan 30, 2026, Jan 17, 2026 and 3 more (6 updates tracked since 2023).

About Mrs. Mary Lee Pantess Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. MARY LEE PANTESS NP (NPI 1043996911) is an individual family provider in Louisville, Kentucky, licensed in Kentucky (4005705) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043996911
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. MARY LEE PANTESSCredential: NP
Location Address924 E BROADWAYLouisville, KY 40204-1057
Mailing Address817 S Jackson StLouisville, KY 40203-2431 · (502) 259-8811
Phone(502) 200-1335
Fax(502) 200-8904
Sole ProprietorNo
Enumeration DateJune 26, 2023
Last NPPES UpdateJuly 27, 20266 updates tracked since enumeration
NPPES CertifiedJuly 27, 2026
✔ NPI 1043996911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in KY · 4005705
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X · License 4005705 (KY)
Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X · License 4005705 (KY)
924 E BROADWAY, Louisville, KY 40204
Open in Google Maps ↗

Other Names 1

Former Name (1)Mrs. Mary Lee Aboulhosn Np

Other Identifiers 2

Medicaid7100912570KY
Medicaid7100936110KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Mary Lee Pantess Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Mary Pantess reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Shively First Health Care, LLC
Same address
Rehabilitation, Substance Use Disorder
924 E BROADWAY
Louisville, KY 40204
  • Reassigned Medicare billing, Kentucky enrollment
NPI 1811775679 (502) 200-1335
Kiosk Medicine Kentucky LLC
6.2 mi
Family
3039 BRECKENRIDGE LN
Louisville, KY 40220
  • Reassigned Medicare billing, Kentucky enrollment
  • 488 clinicians in this Medicare group
NPI 1205885035 (502) 451-4555

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40204 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHIVELY FIRST HEALTH CARE, LLC
Clinic/Center (Rehabilitation, Substance Use Disorder)
924 E BROADWAY
LOUISVILLE, KY 40204
Jefferson County (502) 200-1335

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Pantess's NPI number?

The NPI number for Mary Pantess is 1043996911. It was assigned to this individual provider in the NPPES registry on June 26, 2023. The provider is also known as Mrs. Mary Lee Aboulhosn Np.

Where is Mary Pantess located?

Mary Pantess practices at 924 E Broadway, Louisville, KY 40204. The listed phone number is (502) 200-1335.

What is Mary Pantess's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Mary Pantess enrolled in Medicare?

Yes. Mary Pantess is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Mary Pantess's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Pantess reassigns Medicare benefits to 2 organizations: Shively First Health Care, LLC (Louisville, KY) and Kiosk Medicine Kentucky LLC (Louisville, KY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Pantess's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mary Pantess accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter of Tennessee list Mary Pantess as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mary Pantess was last updated on July 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.