NPIMap

Individual provider Active NPI

Danielle Detelich, MD

  • Surgical Critical Care Physician
  • Lexington, KY
National Provider Identifier
1427461920
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
58217 Issued in KY
Practice address
740 S Limestone Ste L119
Lexington, KY 40536-1552
Phone
(859) 257-3253
Fax
(859) 323-1203
NPI assigned
Jun 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 260094 MA
Surgical Critical Care Physician 2086S0102X 58217 KY Primary

Addresses

Primary practice location

740 S Limestone Ste L119
Lexington, KY 40536-1552

Mailing address

740 S Limestone Ste L119
Lexington, KY 40536-0001
Phone (859) 257-3253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230727001089 KY Practitioner - General Surgery 8729377676 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
R Franklin University of Med & Sci/Chicago Medical School, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
H2 Rehabilitation Services of Kentucky, LLCGroup PAC ID 5799682688, shared by 7 NPIs, 187 clinicians
Kentucky Medical Services Foundation, IncGroup PAC ID 5698689909, 949 clinicians

Practice addresses (Care Compare)

193 Glades Rd
Berea, KY 40403-2261
Phone (859) 956-1055

740 S Limestone St
Lexington, KY 40508-1683
Phone (859) 257-8562

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
68.25
Promoting interoperability
100
Improvement activities
40
Cost
72.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58217KYMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky CurrentSince Jul 14, 2023 Accepting new patients
Kentucky Medical Services Foundation, Inc Surgery CurrentSince Jul 14, 2023 Accepting new patients
University of Kentucky Past Accepting new patients

Locations

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

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

Interoperability endpoints

  • Direct secure messaging: ddetelich305584@ukhcdirect.org

Organizations & group practices 3

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 5

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": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1427461920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE STE L119",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001",
            "telephone_number": "859-257-3253",
            "fax_number": "859-323-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE STE L119",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405361552",
            "telephone_number": "859-257-3253",
            "fax_number": "859-323-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETELICH",
        "first_name": "DANIELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-03",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "260094",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "KY",
            "license": "58217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.