Sundeep Singh Bajwa, DO
Individual provider Active NPI Hospitalist Physician · Fort Thomas, KY
NPI 1417486374 · NPPES record last updated Dec 19, 2023
Key facts
- NPI
- 1417486374
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Hospitalist Physician 208M00000X
- License
- 04754 (KY)
- Practice address
- 85 N Grand Ave
Fort Thomas, KY 41075-4027 - Phone
- (859) 301-8074
- Fax
- (859) 301-4945
- NPI assigned
- Jun 5, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Hospitalist
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Summit Medical Group Inc
Practice addresses (Care Compare)
85 N Grand Ave
Fort Thomas, KY 41075-1793
Phone (859) 781-3110
Hospital & facility affiliations
- St Elizabeth Florence
- St Elizabeth Ft Thomas
- St Elizabeth Edgewood
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.01 of 100
- Quality
- 86.02
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200727002915 | KY | Practitioner - Hospitalist | 8729357355 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34-013821 | OH | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Group, Inc. | Current |
Accepting new patients | |
| Summit Medical Group, Inc | Internal Medicine | Current |
Accepting new patients |
| St Elizabeth Medical Center, Inc | Past | Accepting new patients | |
| St Elizabeth Medical Center, Inc | Past | Accepting new patients |
Locations
1500 James Simpson Jr Way
Covington, KY 41011
Phone (859) 655-4353
1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000
4900 Houston Rd
Florence, KY 41042
Phone (859) 212-5200
85 N Grand Ave
Fort Thomas, KY 41075
Phone (859) 572-3100
1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700
300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217
Interoperability endpoints
- sbajwa329579@direct-prd.stelizabeth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 04754 | KY | |
| Internal Medicine Physician | 207R00000X | 34-013821 | OH | |
| Hospitalist Physician | 208M00000X | 04754 | KY | Yes |
Addresses
Primary practice location
85 N Grand Ave
Fort Thomas, KY 41075-4027
Mailing address
PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 344-5555
Other providers in Fort Thomas, KY
- Katherine Rose Andriacco - Johnson
- Jan Victoria Ankenbauer
- Kimberly Danielle Arias
- Gail Lynn Bacis
- Jennifer N Bailey
- Russell Alan Ball
- Dakshika Wijayanthie Bandaranayake
- Abdul Latif Banire
- Christopher Banner
- Shelley Barnett
All providers in Fort Thomas, KY · Hospitalist Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 19, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.