CARMEN THOMAS
NPI 1538612882
Nurse Practitioner - Family in Louisville, KY

Active since August 03, 2016PECOS EnrolledAccepts Medicare Assignment
95.5/100
CMS Quality Rating
4423 BARDSTOWN RD, LOUISVILLE, KY 40218(502) 749-7909 Get Directions Write a Review

NPPES record last updated: February 10, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Feb 10, 2022, Aug 20, 2019 (2 updates tracked since 2019).

About Carmen Thomas NPPES

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

CARMEN THOMAS (NPI 1538612882) is an individual family provider in Louisville, Kentucky, licensed in Kentucky (3010811) and active in the NPI registry since August 2016. She is enrolled in Medicare PECOS, is affiliated with Baptist Health Floyd, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1538612882
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameCARMEN THOMAS
Location Address4423 BARDSTOWN RDLouisville, KY 40218-3235
Mailing AddressPo Box 909Louisville, KY 40201-0909
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateAugust 3, 2016
Last NPPES UpdateFebruary 10, 20222 updates tracked since enumeration
NPPES CertifiedFebruary 10, 2022
NPI 1538612882 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
Licenses Licensed in KY · 3010811 Licensed in IN · 28142796A
4423 BARDSTOWN RD, Louisville, KY 40218

Accepted 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

Carmen Thomas 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 ID4789971680
PECOS Enrollment IDI20160920002962
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 5

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
40 services40 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
31 services30 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
26 services26 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.
26 services17 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.
19 services19 patients

Hospital Affiliations CMS Care Compare 2

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

Baptist Health Floyd

Acute Care Hospitals · New Albany, IN
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150044
Location1850 State StNew Albany, IN 47150 · Floyd County
Emergency services Birthing friendly

Baptist Health Lagrange

Acute Care Hospitals · La Grange, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180138
Location1025 New Moody LaneLa Grange, KY 40031 · Oldham County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40218 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.

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.

95.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality89.59
Promoting Interoperability100
Improvement Activities40

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.

Family Medicine
4423 BARDSTOWN RD
LOUISVILLE, KY 40218
Nurse Practitioner
4423 BARDSTOWN RD
LOUISVILLE, KY 40218
Internal Medicine
4423 BARDSTOWN RD
LOUISVILLE, KY 40218
Family Medicine
4423 BARDSTOWN RD
LOUISVILLE, KY 40218
Nurse Practitioner (Family)
4423 BARDSTOWN RD
LOUISVILLE, KY 40218
Nurse Practitioner
4423 BARDSTOWN RD
LOUISVILLE, KY 40218
Nurse Practitioner (Family)
4423 BARDSTOWN RD
LOUISVILLE, KY 40218
Physician Assistant
4423 BARDSTOWN RD
LOUISVILLE, KY 40218

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 Carmen Thomas's NPI number?

The NPI number for Carmen Thomas is 1538612882. It was assigned to this individual provider in the NPPES registry on August 3, 2016.

Where is Carmen Thomas located?

Carmen Thomas practices at 4423 Bardstown Rd, Louisville, KY 40218. The listed phone number is (502) 749-7909.

What is Carmen Thomas's specialty?

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

Is Carmen Thomas enrolled in Medicare?

Yes. Carmen Thomas 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 Carmen Thomas accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and CareSource list Carmen Thomas 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 Carmen Thomas affiliated with any hospitals?

According to CMS data, Carmen Thomas is affiliated with Baptist Health Floyd and Baptist Health Lagrange.

When was this NPI record last updated?

The NPPES record for Carmen Thomas was last updated on February 10, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.