Provider Demographics
NPI:1962423285
Name:HOSPITAL INTERNAL MEDICINE ASSOCIATES, PLLC
Entity type:Organization
Organization Name:HOSPITAL INTERNAL MEDICINE ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:N
Authorized Official - Last Name:NASRATY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-948-5120
Mailing Address - Street 1:11303 PEPPERMINT ST
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-6617
Mailing Address - Country:US
Mailing Address - Phone:812-948-5120
Mailing Address - Fax:
Practice Address - Street 1:200 ABRAHAM FLEXNER WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-2877
Practice Address - Country:US
Practice Address - Phone:812-948-5120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY2436477000OtherPASSPORT ADVANTAGE
KY1106141OtherPASSPORT
KY65932881Medicaid
KY2436477000OtherPASSPORT ADVANTAGE