Individual provider Active NPI

Phillip Lee Kiser, M.D.

  • Family Medicine Physician
  • Newport, KY
National Provider Identifier
1356446447
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40616 Issued in KY
Practice address
1400 Grand Ave
Newport, KY 41071-2570
Phone
(859) 905-3070
Fax
(859) 441-1348
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 00046836 WA
Family Medicine Physician 207Q00000X 40616 KY Primary

Addresses

Primary practice location

1400 Grand Ave
Newport, KY 41071-2570

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 905-3070

Other identifiers 3

IdentifierTypeStateIssuer
40616OtherKYMEDICAL LICENSE
7100015240MedicaidKY
000000511094OtherKYANTHEM

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
I20070822000569 KY Practitioner - Family PracticePractitioner - Emergency Medicine 9638261696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

1400 Grand Ave
Newport, KY 41071-2570
Phone (859) 301-5901

Hospital & facility affiliations

  • St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035

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
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00046836WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc Family Medicine Current Accepting new patients
Summit Medical Group, Inc. Family Medicine CurrentSince May 30, 2018 Accepting new patients
Summit Medical Group, Inc. CurrentSince May 30, 2018 Accepting new patients
The Ophthalmology Group, LLC PastSince Aug 1, 2016 Accepting new patients

Locations

334 Thomas More Pkwy
Ste 200
Crestview Hills, KY 41017
Phone (859) 344-3737

405 Violet Rd
Crittenden, KY 41030
Phone (859) 428-1610

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

2626 Alexandria Pike
Highland Heights, KY 41076
Phone (859) 757-0434

1400 Grand Ave
Newport, KY 41071
Phone (859) 905-3070

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

Interoperability endpoints

  • Direct secure messaging: pkiser229518@direct-prd.stelizabeth.com

Organizations & group practices 4

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 1

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1356446447",
    "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": "859-905-3070",
            "fax_number": "859-441-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 GRAND AVE",
            "city": "NEWPORT",
            "state": "KY",
            "postal_code": "410712570",
            "telephone_number": "859-905-3070",
            "fax_number": "859-441-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISER",
        "first_name": "PHILLIP",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "00046836",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "40616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "40616",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100015240",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000511094",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, KY

Sources for this page

Verify at the official NPI Registry.