ALICIA JEANNE WALDRAB APRN
NPI 1205399482
Nurse Practitioner - Family in Louisville, KY

Q: What is Alicia Waldrab's NPI number?

The NPI number for Alicia Waldrab is 1205399482. It was assigned to this individual provider in the NPPES registry on April 13, 2019.

Q: What is Alicia Waldrab's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Alicia Waldrab was last updated on June 12, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 13, 2019PECOS Enrolled

2215 PORTLAND AVE, LOUISVILLE, KY 40212(502) 774-8631 Get Directions Write a Review

NPPES record last updated: June 12, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 12, 2023, Oct 12, 2022, Mar 10, 2020 and 1 more (4 updates tracked since 2019).

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About Alicia Jeanne Waldrab Aprn NPPES

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

ALICIA JEANNE WALDRAB APRN (NPI 1205399482) is an individual family provider in Louisville, Kentucky, licensed in Kentucky (3017979) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205399482

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameALICIA JEANNE WALDRABCredential: APRN

Location Address2215 PORTLAND AVELouisville, KY 40212-1033

Mailing Address2215 Portland AveLouisville, KY 40212-1033 · (502) 953-4700

Phone(502) 774-8631

Sole ProprietorNo

Enumeration DateApril 13, 2019

Last NPPES UpdateJune 12, 20234 updates tracked since enumeration

NPPES CertifiedJune 12, 2023

✔ NPI 1205399482 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in KY · 3017979

2215 PORTLAND AVE, Louisville, KY 40212

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Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alicia Jeanne Waldrab Aprn 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40212 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.

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Other Providers at the Same Location NPPES 20

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

JAIVANTI LOHANO MD

Family Medicine