Active NPI
Konstantinos Kossidas, M.D
- Clinical Cardiac Electrophysiology Physician
- Edgewood, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Cardiac Electrophysiology Physician
- License
- 58701
- Practice address
- 711 Medical Village Dr
Edgewood, KY 41017-3439 - Phone
- (859) 331-3353
- Fax
- (859) 331-3326
- NPI assigned
- Apr 21, 2009
- Last updated
- Dec 17, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | 2020012896 | MO | |
| Cardiovascular Disease Physician | 207RC0000X | 2020012896 | MO | |
| Cardiovascular Disease Physician | 207RC0000X | 58701 | KY | |
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | 58701 | KY | Primary |
| Cardiovascular Disease Physician | 207RC0000X | 01093098A | IN | |
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | 01093098A | IN |
Addresses
Primary practice location
711 Medical Village Dr
Edgewood, KY 41017-3439
Mailing address
PO Box 636324
Cincinnati, OH 45263-6324
Phone (859) 331-3353
Other practice location 1
600 Wilson Creek Rd
Lawrenceburg, IN 47025-2751
Phone (859) 331-3353
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Cardiac Electrophysiology
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Summit Medical Group Inc
Practice addresses (Care Compare)
600 Wilson Creek Rd
Lawrenceburg, IN 47025-2751
Phone (859) 301-2465
711 Medical Village Dr
Edgewood, KY 41017-3439
Phone (859) 331-3353
7388 Turfway Rd
Florence, KY 41042-1381
Phone (859) 287-3045
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.01 of 100
- Quality
- 86.02
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Pacemaker insertion or repair | 19 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020012896 | MO | MD | Cardiovascular Disease Physician |
| 58701 | KY | MD | Clinical Cardiac Electrophysiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Group, Inc. | Current | Accepting new patients | |
| St Elizabeth Medical Center, Inc | Current | Accepting new patients | |
| Summit Medical Group, Inc | Current | Accepting new patients | |
| Summit Medical Group, Inc | Current | Accepting new patients | |
| St Elizabeth Medical Center, Inc | Current | Accepting new patients |
Locations
204 Bridgeway St
Aurora, IN 47001
Phone (812) 926-3133
600 Wilson Creek Rd
Lawrenceburg, IN 47025
Phone (812) 532-2700
1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000
711 Medical Village Dr
Edgewood, KY 41017
Phone (859) 287-3045
7388 Turfway Rd
Florence, KY 41042
Phone (606) 331-9000
1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700
1400 Grand Ave
Newport, KY 41071
Phone (859) 905-3070
238 Barnes Rd
Williamstown, KY 41097
Phone (859) 292-4000
300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217
Interoperability endpoints
- kkossidas415418@direct-prd.stelizabeth.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba St. Elizabeth Healthcare
- Physician Assistant
- Erlanger, KY
- NPI 1932187937
IN
-
dba St. Elizabeth Physicians Behavioral Health
- Psychiatry Physician
- Erlanger, KY
- NPI 1508287640
IN
-
dba St. Elizabeth Physicians
- Family Medicine Physician
- Erlanger, KY
- NPI 1750343216
-
- Community/Retail Pharmacy
- Florence, KY
- NPI 1104699453
-
dba St. Elizabeth Physicians
- Foot & Ankle Surgery Podiatrist
- Crestview Hills, KY
- NPI 1043188378
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St Elizabeth Florence
- General Acute Care Hospital
- Florence, KY
- NPI 1154365062
-
- General Acute Care Hospital
- Edgewood, KY
- NPI 1467492421
-
dba St Elizabeth Ft. Thomas
- General Acute Care Hospital
- Fort Thomas, KY
- NPI 1740221795
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765929600000",
"number": "1851535827",
"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": "859-331-3353",
"fax_number": "859-331-3326"
},
{
"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": "859-331-3353",
"fax_number": "859-331-3326"
}
],
"practiceLocations": [
{
"address_1": "600 Wilson Creek Rd",
"address_purpose": "LOCATION",
"city": "Lawrenceburg",
"state": "IN",
"postal_code": "470252751",
"country_code": "US",
"telephone_number": "859-331-3353",
"fax_number": "859-331-3326",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOSSIDAS",
"first_name": "KONSTANTINOS",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-21",
"last_updated": "2025-12-17",
"certification_date": "2025-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
"state": "MO",
"license": "2020012896",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "MO",
"license": "2020012896",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "KY",
"license": "58701",
"primary": false
},
{
"code": "207RC0001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
"state": "KY",
"license": "58701",
"primary": true
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IN",
"license": "01093098A",
"primary": false
},
{
"code": "207RC0001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
"state": "IN",
"license": "01093098A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Edgewood, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.