PEARL MEDICAL PRACTICE PLLC
NPI 1114261203
Clinic/Center - Primary Care in Louisville, KY
About Pearl Medical Practice Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PEARL MEDICAL PRACTICE PLLC (NPI 1114261203) is a healthcare organization registered as a primary care in Louisville, Kentucky and active in the NPI registry since November 2012. The organization holds an CLIA Accreditation certificate valid through December 10, 2027 and lists Osawaru Omoruyi, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 5
Other Identifiers 3
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Pearl Medical Practice Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Pearl Medical Practice PLLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
Land O Lakes, FL 34638
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Accreditation 18D2085247
Pearl Medical Practice, PLLC · Louisville, KYFrequently 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 Pearl Medical Practice PLLC's NPI number?
The NPI number for Pearl Medical Practice PLLC is 1114261203. It was assigned to this organization in the NPPES registry on November 15, 2012.
Where is Pearl Medical Practice PLLC located?
Pearl Medical Practice PLLC is located at 4200 Gardiner View Ave Suite 200, Louisville, KY 40213. The listed phone number is (502) 456-0494.
What is Pearl Medical Practice PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Pearl Medical Practice PLLC enrolled in Medicare?
Yes. Pearl Medical Practice PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Pearl Medical Practice PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Pearl Medical Practice PLLC, in Family Practice and Nurse Practitioner. A 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 the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Pearl Medical Practice PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Accreditation (number 18D2085247) is associated with this NPI, valid through December 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Pearl Medical Practice PLLC accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee, Anthem Blue Cross and Blue Shield and Blue Cross and Blue Shield of Texas and 1 other insurer list Pearl Medical Practice PLLC 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 Pearl Medical Practice PLLC was last updated on October 2, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years 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.
# Pearl Medical Practice Pllc · NPI 1114261203
Primary Care organization in Louisville, Kentucky. Organization record, active in the CMS NPPES registry since November 15, 2012.
## Identity
- **NPI:** 1114261203 (Entity type: Organization)
- **Enumerated:** November 15, 2012
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Osawaru Omoruyi, PRESIDENT
## Practice location
- **Address:** 4200 GARDINER VIEW AVE, SUITE 200, Louisville, KY 40213-1877
- **Phone:** (502) 456-0494 · **Fax:** (502) 456-0496
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (2), Family Practice (1); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 2, 2015
- **Other identifiers:** Medicaid 7100259660 (KY); Medicare PIN K080050 (KY); Medicaid 7100267920 (KY)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1114261203) · Data from the CMS NPPES public registry.