Individual provider Active NPI

Karl Stephen Ulicny II, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Edgewood, KY
National Provider Identifier
1124085980
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
29615 Issued in KY
Practice address
711 Medical Village Dr
Edgewood, KY 41017
Phone
(859) 301-9010
Fax
(859) 301-9018
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 29615 KY Primary

Addresses

Primary practice location

711 Medical Village Dr
Edgewood, KY 41017

Mailing address

PO Box 636324
Cincinnati, OH 45263-6324
Phone (859) 301-9010

Other identifiers 3

IdentifierTypeStateIssuer
64932783MedicaidKY
200046180MedicaidIN
0728752MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Elizabeth Medical Center, Inc Current Accepting new patients

Locations

20 Medical Village Dr
Ste 204
Edgewood, KY 41017
Phone (859) 301-5959

20 Medical Village Dr
Edgewood, KY 41017
Phone (859) 344-1600

20 Medical Village Dr
Ste 105
Edgewood, KY 41017
Phone (859) 426-7000

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

20 Medical Village Dr
Ste 271
Edgewood, KY 41017

711 Medical Village Dr
Edgewood, KY 41017
Phone (859) 287-3045

Interoperability endpoints

  • Direct secure messaging: kulicny24733@direct-prd.stelizabeth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1124085980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636324",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636324",
            "telephone_number": "859-301-9010",
            "fax_number": "859-301-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "41017",
            "telephone_number": "859-301-9010",
            "fax_number": "859-301-9018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULICNY",
        "first_name": "KARL",
        "middle_name": "STEPHEN",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "KY",
            "license": "29615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64932783",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200046180",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0728752",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.