Mohammad K Gayasaddin, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

39269 Issued in KY

Practice address

914 N Dixie Ave
Suite 301
Elizabethtown, KY 42701-2520

Phone

(270) 765-2220

Fax

(270) 765-2226

NPI assigned

Aug 26, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mohammad.khaja.gayasaddin.1@13956.direct.athenahealth.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.

• Mohammad K Gayasaddin

  • Specialist
  • Elizabethtown, KY
  • NPI 1114176682
  NPD (past) Authorized official
• Northern Kentucky Heart PSC

  • Cardiovascular Disease Physician
  • Crestview Hills, KY
  • NPI 1700879491
  NPD (past)

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263254400000",
    "number": "1508859315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 N DIXIE AVE",
            "address_2": "SUITE 301",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012520",
            "telephone_number": "270-765-2220",
            "fax_number": "270-765-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 N DIXIE AVE",
            "address_2": "SUITE 301",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012520",
            "telephone_number": "270-765-2220",
            "fax_number": "270-765-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYASADDIN",
        "first_name": "MOHAMMAD",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2010-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "39269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6409216600",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Joseph Garrett, PA-C
• Jennifer Brooke Garrigus
• John Paul Garrity, CRNA
• Rebecca Marie Gash, BSW, TCADA, CADC-A
• Vicente Gavieres, MD
• Roger Lewis Gelperin, D.O.
• Genesis Counseling LLC
• Genesis Rehab
• Genesisrehab Services
• Carol George, ATC

• Cardiovascular Disease Physician in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Cardiovascular Disease Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.