Individual provider Active NPI

Damir Kusmic, MD

  • Gastroenterology Physician
  • Lexington, KY
National Provider Identifier
1780039727
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
58602 Issued in KY
Practice address
160 N Eagle Creek Dr Ste 202
Lexington, KY 40509-2125
Phone
(859) 263-0022
Fax
(859) 263-4666
NPI assigned
Apr 27, 2016
Last updated
Jul 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 29143 WV
Gastroenterology Physician 207RG0100X 58602 KY Primary

Addresses

Primary practice location

160 N Eagle Creek Dr Ste 202
Lexington, KY 40509-2125

Mailing address

PO Box 936
London, KY 40743-0936
Phone (606) 330-7835

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
I20230803002309 KY Practitioner - Gastroenterology 4880980424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Kentucky College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

160 N Eagle Creek Dr
Suite 202
Lexington, KY 40509-2125
Phone (859) 263-0022

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy47
Upper gastrointestinal (GI) endoscopy for acid reflux140

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29143WVMDInternal Medicine Physician
58602KYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentuckyone Health Medical Group, Inc. Internal Medicine CurrentSince Sep 1, 2023 Accepting new patients
Kentuckyone Health Medical Group, Inc. CurrentSince Sep 1, 2023 Accepting new patients

Locations

305 Estill St
Berea, KY 40403
Phone (859) 986-1415

1401 Harrodsburg Rd
Ste A300
Lexington, KY 40504
Phone (859) 313-4744

160 N Eagle Creek Dr
Ste 202
Lexington, KY 40509
Phone (859) 263-0022

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1780039727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407430936",
            "telephone_number": "606-330-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 N EAGLE CREEK DR STE 202",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092125",
            "telephone_number": "859-263-0022",
            "fax_number": "859-263-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSMIC",
        "first_name": "DAMIR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-27",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "29143",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "58602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.