Individual provider Active NPI

Sulsal Ul Haque, M.D.

  • Hematology & Oncology Physician
  • Edgewood, KY
National Provider Identifier
1457618605
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
TP627 Issued in KY
Practice address
1 Medical Village Dr
Edgewood, KY 41017-3403
Phone
(859) 301-4000
Fax
(859) 301-4001
NPI assigned
Apr 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 57.020948 OH
Hematology & Oncology Physician 207RH0003X 57.020948 OH
Hematology & Oncology Physician 207RH0003X TP627 KY Primary

Addresses

Primary practice location

1 Medical Village Dr
Edgewood, KY 41017-3403

Mailing address

PO Box 636324
Cincinnati, OH 45263-6324
Phone (859) 301-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210804001562 OH Practitioner - Hematology/Oncology 3870732506 Reassigns benefits to 1 organization
I20250305001743 KY Practitioner - Hematology/Oncology 3870732506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2006
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)

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 301-2237

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.020948OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Elizabeth Medical Center, Inc Internal Medicine CurrentSince Mar 31, 2025 Accepting new patients
St Elizabeth Medical Center, Inc CurrentSince Mar 31, 2025 Accepting new patients
University of Cincinnati Physicians Company, LLC Internal Medicine CurrentSince Aug 1, 2021 Accepting new patients
University of Cincinnati Medical Center, LLC Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

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

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

3199 Highland Ave
#781
Cincinnati, OH 45219
Phone (513) 585-4505

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

Interoperability endpoints

  • Direct secure messaging: shaque14491@direct.uchealth.com
  • Direct secure messaging: shaque106943@direct.metrohealth.net

Organizations & group practices 5

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 3

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": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1457618605",
    "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": "859-301-4000",
            "fax_number": "859-301-4001"
        },
        {
            "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": "859-301-4000",
            "fax_number": "859-301-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAQUE",
        "first_name": "SULSAL UL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.020948",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OH",
            "license": "57.020948",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "KY",
            "license": "TP627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.