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ANDREA HERNDON PA
NPI 1497108278
Physician Assistant in Louisville, KY

Active since July 18, 2016PECOS EnrolledAccepts Medicare Assignment
73.19/100
CMS Quality Rating
225 ABRAHAM FLEXNER WAY, LOUISVILLE, KY 40202(502) 568-6616 Get Directions Write a Review

NPPES record last updated: November 18, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 18, 2021, Sep 15, 2016 (2 updates tracked since 2016).

About Andrea Herndon Pa NPPES

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

ANDREA HERNDON PA (NPI 1497108278) is an individual physician assistant in Louisville, Kentucky, licensed in Kentucky (PA2144) and active in the NPI registry since July 2016. She is enrolled in Medicare PECOS, is affiliated with Jewish Hospital & St Mary's Healthcare, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1497108278
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameANDREA HERNDONCredential: PA
Location Address225 ABRAHAM FLEXNER WAYLouisville, KY 40202-1882
Mailing AddressPo Box 909Louisville, KY 40201-0909 · (502) 568-6616
Phone(502) 568-6616
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJuly 18, 2016
Last NPPES UpdateNovember 18, 20212 updates tracked since enumeration
NPPES CertifiedNovember 18, 2021
✔ NPI 1497108278 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in KY · PA2144
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
225 ABRAHAM FLEXNER WAY, Louisville, KY 40202
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Other Identifiers 1

Medicaid7100426350KY

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 and accepts Medicare assignment

Andrea Herndon Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5799073821
PECOS Enrollment IDI20161005002032
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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
192 services58 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
47 services40 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
25 services23 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
24 services24 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Jewish Hospital & St Mary's Healthcare

Acute Care Hospitals · Louisville, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180040
Location200 Abraham Flexner WayLouisville, KY 40202 · Jefferson County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40202 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
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

73.19/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality58.74
Promoting Interoperability100
Improvement Activities40
Cost51.91

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.

KATLEEN LIBBERECHT MD
Student in an Organized Health Care Education/Training Program
225 ABRAHAM FLEXNER WAY, SUITE 850
LOUISVILLE, KY 40202
Jefferson County (502) 561-4263
LEAH D ASHBY APRN
Nurse Practitioner
225 ABRAHAM FLEXNER WAY, SUITE 305
LOUISVILLE, KY 40202
Jefferson County (502) 585-4321
NEUROSURGICAL GROUP OF GREATER LOUISVILLE AND SO IN PSC
Specialist
225 ABRAHAM FLEXNER WAY, SUITE 505
LOUISVILLE, KY 40202
Jefferson County (502) 584-4121
DR. RICHARD M LEVIN M.D.
Specialist
225 ABRAHAM FLEXNER WAY, SUITE 501
LOUISVILLE, KY 40202
Jefferson County (502) 584-7787
NARESH K SOLANKHI MD
Internal Medicine (Interventional Cardiology)
225 ABRAHAM FLEXNER WAY, SUITE 305
LOUISVILLE, KY 40202
Jefferson County (502) 585-4321
MISS AINHOA COSTAS CHAVARRI M.D.
Surgery (Surgery of the Hand)
225 ABRAHAM FLEXNER WAY, SUITE 850
LOUISVILLE, KY 40202
Jefferson County (502) 562-0312
BETTY J LAY OTR/L
Occupational Therapist (Hand)
225 ABRAHAM FLEXNER WAY, SUITE 650
LOUISVILLE, KY 40202
Jefferson County (502) 561-4295
MICHELLE CARDWELL FNP
Nurse Practitioner (Family)
225 ABRAHAM FLEXNER WAY, OUTPATIENT CARE CENTER - ENDOSCOPY UNIT
LOUISVILLE, KY 40202
Jefferson County (502) 587-4011

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 Andrea Herndon's NPI number?

The NPI number for Andrea Herndon is 1497108278. It was assigned to this individual provider in the NPPES registry on July 18, 2016.

Where is Andrea Herndon located?

Andrea Herndon practices at 225 Abraham Flexner Way, Louisville, KY 40202. The listed phone number is (502) 568-6616.

What is Andrea Herndon's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Andrea Herndon enrolled in Medicare?

Yes. Andrea Herndon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Andrea Herndon accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield and 1 other insurer list Andrea Herndon 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.

Is Andrea Herndon affiliated with any hospitals?

According to CMS data, Andrea Herndon is affiliated with Jewish Hospital & St Mary's Healthcare.

When was this NPI record last updated?

The NPPES record for Andrea Herndon was last updated on November 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.