Individual provider Active NPI

Aishwarya Rushyal Shyamraj, M.D.

  • Gastroenterology Physician
  • Florence, KY
National Provider Identifier
1033485644
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
52496 Issued in KY
Practice address
4900 Houston Rd
Florence, KY 41042-4824
Phone
(859) 331-6466
Fax
(859) 344-7930
NPI assigned
Mar 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34440 AL
Gastroenterology Physician 207RG0100X 52496 KY Primary

Addresses

Primary practice location

4900 Houston Rd
Florence, KY 41042-4824

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 331-6466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190829002384 KY Practitioner - Gastroenterology 3577795368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

4900 Houston Rd
Florence, KY 41042-4824
Phone (859) 212-7700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy80
Upper gastrointestinal (GI) endoscopy for acid reflux93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34440ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. Internal Medicine CurrentSince Aug 26, 2019 Accepting new patients
Summit Medical Group, Inc Internal Medicine Current Accepting new patients
Summit Medical Group, Inc. CurrentSince Aug 26, 2019 Accepting new patients

Locations

651 Centre View Blvd
Crestview Hills, KY 41017
Phone (859) 341-6660

4900 Houston Rd
Florence, KY 41042
Phone (859) 212-5200

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Interoperability endpoints

  • Direct secure messaging: ashyamraj293281@direct-prd.stelizabeth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1033485644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-331-6466",
            "fax_number": "859-344-7930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 HOUSTON RD",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410424824",
            "telephone_number": "859-331-6466",
            "fax_number": "859-344-7930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHYAMRAJ",
        "first_name": "AISHWARYA",
        "middle_name": "RUSHYAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "34440",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "52496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, KY

Sources for this page

Verify at the official NPI Registry.