Individual provider Active NPI

Konrad Kijewski, M.D.

  • Interventional Pain Medicine Physician
  • Louisville, KY
National Provider Identifier
1184767048
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
40634 Issued in KY
Practice address
4130 Dutchmans LN Ste 200
Louisville, KY 40207-4709
Phone
(502) 897-1794
Fax
(502) 897-3852
NPI assigned
Feb 14, 2007
Last updated
Dec 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 40634 KY Primary

Addresses

Primary practice location

4130 Dutchmans LN Ste 200
Louisville, KY 40207-4709

Mailing address

4130 Dutchmans LN Ste 300
Louisville, KY 40207-4710
Phone (502) 897-1794

Other practice location 1

3605 Northgate Ct Ste 207
New Albany, IN 47150-6422
Phone (502) 897-1794

Other identifiers 2

IdentifierTypeStateIssuer
64130453MedicaidKY
300028796MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070806000306 KY Practitioner - Anesthesiology 0749371730 Reassigns benefits to 2 organizations
I20091209000646 IN Practitioner - AnesthesiologyPractitioner - Interventional Pain ManagementPractitioner - Pain Management 0749371730 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, shared by 31 NPIs, 2,431 clinicians

Practice addresses (Care Compare)

1850 State St
New Albany, IN 47150-4990
Phone (812) 542-4921

2400 Eastpoint Pkwy
Suite 470
Louisville, KY 40223-4154
Phone (502) 897-6579

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.05 of 100Reported as group
Promoting interoperability
93
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40634KYMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Current Accepting new patients
Baptist Health Medical Group Inc CurrentSince Sep 1, 2025 Accepting new patients
Baptist Health Medical Group, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Sep 1, 2025 Accepting new patients
University Anesthesiology Associates PSC Past Accepting new patients

Locations

1373 N State Road 62
Madison, IN 47250
Phone (812) 801-0196

1425 State St
Ste 100
New Albany, IN 47150
Phone (812) 945-2229

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

2400 Eastpoint Pkwy
Ste 470
Louisville, KY 40223
Phone (502) 897-6579

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

4130 Dutchmans Ln
Ste 200
Louisville, KY 40207
Phone (502) 238-7293

4130 Dutchmans Ln
Ste 300
Louisville, KY 40207

Interoperability endpoints

  • Direct secure messaging: konrad.kijewski.1@25506.direct.athenahealth.com

Organizations & group practices 6

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

Hospital & facility affiliations 2

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1184767048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 DUTCHMANS LN STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074710",
            "telephone_number": "502-897-1794",
            "fax_number": "502-897-3852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 DUTCHMANS LN STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074709",
            "telephone_number": "502-897-1794",
            "fax_number": "502-897-3852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3605 Northgate Ct Ste 207",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "IN",
            "postal_code": "471506422",
            "country_code": "US",
            "telephone_number": "502-897-1794",
            "fax_number": "502-897-3852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIJEWSKI",
        "first_name": "KONRAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "KY",
            "license": "40634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64130453",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300028796",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.