Edwin Thomas Brott, MD
Individual provider Active NPI Anesthesiology Physician · Ashland, KY
NPI 1063402287 · NPPES record last updated Jan 26, 2011
Key facts
- NPI
- 1063402287
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 31144 (KY)
- Practice address
- 2204 Lexington Avenue
Ashland, KY 41101 - Phone
- (513) 300-0149
- NPI assigned
- Oct 27, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- General Practice
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Triangle Anesthesia Group, PSC
Practice addresses (Care Compare)
260 Hospital Dr
South Williamson, KY 41503-4072
Phone (606) 237-1700
Hospital & facility affiliations
- Hazard Arh Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OH, KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040722001452 | OH | Practitioner - Anesthesiology | 9830179563 | Reassigns benefits to 2 organizations |
| I20040723000581 | KY | Practitioner - General Practice |
9830179563 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62695 | OH | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Ohio Anesthesia Consultants LLC | Anesthesiology | Current |
Accepting new patients |
| PHS Anesthesia Billing, LLC | Anesthesiology | Current |
Accepting new patients |
| Triangle Anesthesia Group PSC | Anesthesiology | Current |
Accepting new patients |
| Queen City Anesthesiologists Inc | Anesthesiology | Past | Accepting new patients |
| Resource Anesthesiology Associates of Oh, LLC | Anesthesiology | Past | Accepting new patients |
| Millenium Anesthesia LLC | Anesthesiology | Past | Accepting new patients |
| Licking Memorial Professional Corporation | Anesthesiology | Past | Accepting new patients |
Locations
13500 Powers Ct
Ste 230
Fort Myers, FL 33912
Phone (239) 610-0784
425 Centre View Blvd
Crestview Hills, KY 41017
Phone (859) 341-3575
100 Medical Dr
Hazard, KY 41701
Phone (606) 439-6600
425 Lewis Hargett Cir
Lexington, KY 40503
Phone (606) 679-9322
260 Hospital Dr
South Williamson, KY 41503
Phone (606) 237-1700
3000 Hospital Dr
Batavia, OH 45103
Phone (513) 557-3209
7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034
1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 31144 | KY | Yes |
| Anesthesiology Physician | 207L00000X | 62695 | OH |
Addresses
Primary practice location
2204 Lexington Avenue
Ashland, KY 41101
Mailing address
2208 South Rd
Cincinnati, OH 45233-4267
Phone (513) 300-0149
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000388319 | Other | ANTHEM BLUE SHIELD | |
| 64311442 | Medicaid | KY | |
| 200366710 | Medicaid | IN | |
| 5087130 | Other | AETNA | |
| 173664 | Other | PRIVATE HEALTH CARE | |
| 000000351385 | Other | ANTHEM BLUE SHIELD | |
| 0950047 | Medicaid | OH |
Other providers in Ashland, KY
- Broadway Clinic Pharmacy Inc
- Johnny Brian Brock
- Michael E. Brock
- Eric H Bronstein
- Shannon Renee Brothers
- April Broun
- Barbara Brown-Clark
- Arielle Renaye Brown
- Ashley Elizabeth Brown
- Candida D Brown
All providers in Ashland, KY · Anesthesiology Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.