Prashant Khullar, M.D.

Primary specialty

Surgical Critical Care PhysicianTaxonomy code 2086S0102X

License

55958 Issued in KY

Practice address

1 Medical Village Dr
Edgewood, KY 41017-3403

Phone

(859) 578-5880

Fax

(859) 578-5881

NPI assigned

Dec 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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

Specialty

General Surgery

Education

Other, 1998

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)

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pkhullar352566@direct-prd.stelizabeth.com

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.

• Summit Medical Group, Inc

  • Family Medicine Physician
  • Erlanger, KY
  • NPI 1750343216
  Medicare reassignment Care Compare group NPD
• Summit Medical Group, Inc.

  • Foot & Ankle Surgery Podiatrist
  • Crestview Hills, KY
  • NPI 1043188378
  NPD
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Edgewood, KY
  • NPI 1467492421
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Edgewood, KY
  • NPI 1467492421
  Care Compare affiliation

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1407030950",
    "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": "859-578-5880",
            "fax_number": "859-578-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "telephone_number": "859-578-5880",
            "fax_number": "859-578-5881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHULLAR",
        "first_name": "PRASHANT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-19",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "IA",
            "license": "RR7990",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "40787",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "KY",
            "license": "TP202",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "KY",
            "license": "55958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Ann Kennedy, APRN, CNP
• Emily Sue Kenner, M.D.
• John Kerman, MD
• Sohaib Taisir Khatib, M.D.
• Saeb Fouad Khoury, M.D.
• Judy Kidwell, RBT
• Taylor Marie Kidwell, MS, BCBA, LBA
• David H Kim, DO
• Patricia Kinney, B.S. PHARM
• Aniket Kiri, DO

• Surgical Critical Care Physician in Edgewood, KY
• Providers in Edgewood, KY by specialty
• Surgical Critical Care Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.