Individual provider Active NPI

Khaldon Jundi, MD

  • Neonatal-Perinatal Medicine Physician
  • Lexington, KY
National Provider Identifier
1336173525
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
29168 Issued in KY
Practice address
170 N Eagle Creek Dr
Lexington, KY 40509-9087
Phone
(859) 967-5778
NPI assigned
Jul 11, 2006
Last updated
Apr 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 29168 KY Primary

Addresses

Primary practice location

170 N Eagle Creek Dr
Lexington, KY 40509-9087

Mailing address

PO Box 24930
Lexington, KY 40524-4930
Phone (859) 272-1146

Other practice location 1

800 Rose St Fl 2
Lexington, KY 40536-9087
Phone (859) 323-5000

Other identifiers 1

IdentifierTypeStateIssuer
64930472MedicaidKY

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
I20040427000093 KY Practitioner - Pediatric Medicine 1456347038 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Health System, Inc. Current Accepting new patients
Saint Joseph Health System, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Kentucky Medical Services Foundation, Inc CurrentSince May 24, 2024 Accepting new patients
University of Kentucky CurrentSince May 24, 2024 Accepting new patients
Bluegrass Newborn Specialists, PLC Neonatal-Perinatal Medicine PastSince Jan 1, 1990 Accepting new patients
Saint Joseph Health System, Inc Past Accepting new patients
Bluegrass Newborn Specialists, PLC PastSince Jan 1, 1990 Accepting new patients

Locations

150 N Eagle Creek Dr
Lexington, KY 40509
Phone (859) 267-9773

170 N Eagle Creek Dr
Lexington, KY 40509
Phone (859) 967-5146

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

800 Rose St
Fl 2
Lexington, KY 40536
Phone (859) 257-4488

1001 Saint Joseph Ln
London, KY 40741
Phone (606) 330-6000

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1336173525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24930",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405244930",
            "telephone_number": "859-272-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 N EAGLE CREEK DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405099087",
            "telephone_number": "859-967-5778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Rose St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405369087",
            "country_code": "US",
            "telephone_number": "859-323-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUNDI",
        "first_name": "KHALDON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "KY",
            "license": "29168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64930472",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.