Individual provider Active NPI

Sudha Prasad Jaganathan, MD

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Edgewood, KY
National Provider Identifier
1447327085
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
License
58033 Issued in KY
Practice address
711 Medical Village Dr
Edgewood, KY 41017-3439
Phone
(859) 287-3045
Fax
(859) 578-3800
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.090787 OH
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X 01090936A IN
Cardiovascular Disease Physician 207RC0000X 58033 KY
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X 58033 KY Primary

Addresses

Primary practice location

711 Medical Village Dr
Edgewood, KY 41017-3439

Mailing address

PO Box 636324
Cincinnati, OH 45263-6324
Phone (859) 301-0124

Other practice location 1

711 Medical Village Dr
Edgewood, KY 41017-3439
Phone (859) 287-3045

Other identifiers 1

IdentifierTypeStateIssuer
2873412MedicaidOH

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
I20230606000294 KY Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Cardiovascular Disease (Cardiology) 2466526652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Advanced Heart Failure and Transplant CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Elizabeth Medical Center, IncGroup PAC ID 0648174623, 187 clinicians

Practice addresses (Care Compare)

711 Medical Village Dr
Edgewood, KY 41017-3439
Phone (859) 301-9010

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.090787OHMDInternal Medicine Physician
01090936AINMDAdvanced Heart Failure and Transplant Cardiology Physician
58033KYMDAdvanced Heart Failure and Transplant Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Elizabeth Medical Center, Inc CurrentSince May 1, 2023 Accepting new patients
St Elizabeth Medical Center, Inc Internal Medicine CurrentSince May 1, 2023 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

711 Medical Village Dr
Edgewood, KY 41017
Phone (859) 287-3045

4900 Houston Rd
Florence, KY 41042
Phone (859) 212-5200

85 N Grand Ave
Fort Thomas, KY 41075
Phone (859) 572-3100

120 Progress Way
Owenton, KY 40359
Phone (502) 227-2229

238 Barnes Rd
Williamstown, KY 41097
Phone (859) 292-4000

Organizations & group practices 2

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 4

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1447327085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636324",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636324",
            "telephone_number": "859-301-0124",
            "fax_number": "859-301-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173439",
            "telephone_number": "859-287-3045",
            "fax_number": "859-578-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 Medical Village Dr",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "KY",
            "postal_code": "410173439",
            "country_code": "US",
            "telephone_number": "859-287-3045",
            "fax_number": "859-578-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAGANATHAN",
        "first_name": "SUDHA",
        "middle_name": "PRASAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.090787",
            "primary": false
        },
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "IN",
            "license": "01090936A",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "58033",
            "primary": false
        },
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "KY",
            "license": "58033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2873412",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.