Provider Demographics
NPI:1235749227
Name:PECACHE, MONICA BAGATSING (MD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:BAGATSING
Last Name:PECACHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-0909
Mailing Address - Country:US
Mailing Address - Phone:502-588-0328
Mailing Address - Fax:
Practice Address - Street 1:225 ABRAHAM FLEXNER WAY STE 700
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3868
Practice Address - Country:US
Practice Address - Phone:502-561-4263
Practice Address - Fax:502-561-4288
Is Sole Proprietor?:No
Enumeration Date:2020-08-04
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01089141A207XS0106X, 2086S0105X
KY57896207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300071738Medicaid
KY7100871300Medicaid
IN01089141AOtherMEDICAL LICENSE