Individual provider Active NPI

Carey Costantini, MD

  • Anesthesiology Physician
  • Edgewood, KY
National Provider Identifier
1881675908
Registry record updated May 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
24111 Issued in 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 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 24111 KY Primary

Addresses

Primary practice location

1 Medical Village Dr
Independent Anesthesiologists PSC
Edgewood, KY 41017-3403

Mailing address

20 Medical Village Dr
Independent Anesthesiologists PSC Suite 258
Edgewood, KY 41017-5401
Phone (859) 341-7246

Other identifiers 6

IdentifierTypeStateIssuer
000000032801OtherANTHEM BLUE SHIELD
0605063MedicaidOH
64241110MedicaidKY
10813849OtherCAQH
200000640MedicaidIN
611077369OtherTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH2 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
I20040420000453 KY Practitioner - Anesthesiology 9830184621 Reassigns benefits to 1 organization
I20100316000744 OH Practitioner - Anesthesiology 9830184621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Ohio State University College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Group Practice IncGroup PAC ID 1254245137, 396 clinicians

Practice addresses (Care Compare)

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 301-2000

10500 Montgomery Rd
Montgomery, OH 45242-4402
Phone (513) 865-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24111KYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Group Practice, Inc Anesthesiology CurrentSince Dec 1, 2015 Accepting new patients
Independent Anesthesiologists PSC Anesthesiology Past Accepting new patients
Trihealth G LLC Past Accepting new patients
Millenium Anesthesia LLC Anesthesiology Past Accepting new patients

Locations

2845 Chancellor Dr
Ste 100
Crestview Hills, KY 41017

340 Thomas More Pkwy
Ste 220
Crestview Hills, KY 41017
Phone (859) 301-2211

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

580 S Loop Rd
Ste 100
Edgewood, KY 41017

7575 US Highway 42
Florence, KY 41042
Phone (606) 283-9100

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

85 N Grand Ave
Fort Thomas, KY 41075
Phone (859) 572-3100

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

Organizations & group practices 4

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273708800000",
    "number": "1881675908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MEDICAL VILLAGE DR",
            "address_2": "INDEPENDENT ANESTHESIOLOGISTS PSC SUITE 258",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175401",
            "telephone_number": "859-341-7246",
            "fax_number": "859-341-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "address_2": "INDEPENDENT ANESTHESIOLOGISTS PSC",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "telephone_number": "859-341-7246",
            "fax_number": "859-341-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTANTINI",
        "first_name": "CAREY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2010-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "24111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE SHIELD",
            "identifier": "000000032801",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0605063",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64241110",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10813849",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200000640",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "611077369",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.