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NPI Code Detail

MEDICARE: DR. JOHN BYRNE RADEMAKER M.D.

MEDICARE:  DR. JOHN BYRNE RADEMAKER  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician01046769IN
2207L00000XAnesthesiology Physician26478KY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
8134960BOTHERINUNICARE MEDICARE
14050067688OTHERINRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000064679OTHERINANTHEM OF INDIANA
2000000064679OTHERINHEALTHLINK
3000000064679OTHERINONE NATION BENEFIT
4000000064679OTHERKYANTHEM OF KENTUCKY
5000000064679OTHERININDIANA COMPREHENSIVE
6129703800OTHERINBLACK LUNG PROGRAM
7000000064679OTHERINUNICARE
9MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
102439494000OTHERINPASSPORT ADVANTAGE
11MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12129703800OTHERINUS DEPT OF LABOR
13200024520OTHERINMANAGED HEALTH SERVICES
151161027OTHERKYPASSPORT
16200024520OTHERINMDWISE HOOSIER ALLIANCE
17MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
18000000064679OTHERINANTHEM SENION ADVANTAGE

General Provider Information

NPI Number : 1033103973
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN BYRNE RADEMAKER M.D.
Provider Business Mailing Address
First Line : PO BOX 909
Second Line :
City : LOUISVILLE
State : KY
Zip : 40201-0909
Country : US
Telephone Number : 502-588-0328
Fax Number :
Provider Business Practice Location Address
First Line : 3920 DUTCHMANS LN
Second Line :
City : LOUISVILLE
State : KY
Zip : 40207-4702
Country : US
Telephone Number : 502-259-6710
Fax Number : 502-259-6704
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2005
Last Update Date : 12/08/2022

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Directions to “ DR. JOHN BYRNE RADEMAKER M.D.” Practice Location

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