Masroor Alam, MD
Individual provider Active NPI Anesthesiology Physician · Edgewood, KY
NPI 1720069388 · NPPES record last updated Feb 23, 2010
Key facts
- NPI
- 1720069388
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 36170 (KY)
- Practice address
- 1 Medical Village Dr
Independent Anesthesiologists PSC
Edgewood, KY 41017-3403 - Phone
- (859) 341-7246
- Fax
- (859) 341-7867
- NPI assigned
- Nov 10, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Anesthesia Group Practice Inc
Southwest Ohio Anesthesia Consultants LLC
Practice addresses (Care Compare)
1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 301-2000
375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 862-2432
4900 Houston Rd
Florence, KY 41042-4824
Phone (859) 212-5200
600 Wilson Creek Rd
Lawrenceburg, IN 47025-2751
Phone (812) 537-1010
7500 State Rd
Cincinnati, OH 45255-2439
Phone (513) 624-4500
85 N Grand Ave
Fort Thomas, KY 41075-1793
Phone (859) 572-3100
Hospital & facility affiliations
- St Elizabeth Edgewood
- St Elizabeth Florence
- St Elizabeth Dearborn Hospital
- St Elizabeth Ft Thomas
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 (3 enrollments) in OH, KY, IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100621000010 | OH | Practitioner - Anesthesiology | 6305976267 | Reassigns benefits to 2 organizations |
| I20100818000581 | KY | Practitioner - Anesthesiology | 6305976267 | Reassigns benefits to 1 organization |
| I20200318000337 | IN | Practitioner - Anesthesiology | 6305976267 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia & Intensive Care Consultants,Inc. | Anesthesiology | Current |
Accepting new patients |
| Anesthesia Group Practice, Inc | Anesthesiology | Current |
Accepting new patients |
| Southwest Ohio Anesthesia Consultants LLC | Anesthesiology | Current |
Accepting new patients |
| Trihealth G LLC | Past | Accepting new patients |
Locations
600 Wilson Creek Rd
Lawrenceburg, IN 47025
Phone (812) 532-2700
425 Centre View Blvd
Crestview Hills, KY 41017
Phone (859) 341-3575
2845 Chancellor Dr
Ste 100
Crestview Hills, KY 41017
340 Thomas More Pkwy
Ste 220
Crestview Hills, KY 41017
Phone (859) 301-2211
20 Medical Village Dr
Ste 258
Edgewood, KY 41017
Phone (606) 341-2666
1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000
580 S Loop Rd
Ste 100
Edgewood, KY 41017
4900 Houston Rd
Florence, KY 41042
Phone (859) 212-5200
85 N Grand Ave
Fort Thomas, KY 41075
Phone (859) 572-3100
375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432
7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034
10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 36170 | KY | Yes |
Addresses
Primary practice location
1 Medical Village Dr
Independent Anesthesiologists PSC
Edgewood, KY 41017-3403
Mailing address
20 Medical Village Dr
Ste 258
Edgewood, KY 41017-5401
Phone (859) 341-7246
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0982843 | Medicaid | OH | |
| 200320150 | Medicaid | IN | |
| 611077369 | Other | TAX ID | |
| 64028475 | Medicaid | KY | |
| 311585770 1720069388 | Other | HEALTHNET | |
| 000000192691 | Other | ANTHEM BLUE SHIELD | |
| 000000642262 | Other | ANTHEM | |
| 11179782 | Other | CAQH |
Other providers in Edgewood, KY
- Advanced Pain Treatment Center
- Advanced Surgical Care
- Kwabena Boakye Agyeman
- Gordon W Air
- Ian Aiuto
- Esmeralda Gabriel Aldama
- Sandra Jean Alexander-Lewis
- Sajen Alexander
- Zaenab Mohamed Bushaala Ali
- Deema Alkapalan
All providers in Edgewood, KY · Anesthesiology 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 Feb 23, 2010. 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.