Individual provider Active NPI

Amaninderapal S Ghotra, MD

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Edgewood, KY
National Provider Identifier
1922397363
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
License
47504 Issued in KY
Practice address
711 Medical Village Dr
Edgewood, KY 41017
Phone
(859) 331-0774
Fax
(859) 578-3800
NPI assigned
Apr 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 47504 KY
Internal Medicine Physician 207R00000X R2754 KY
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X 47504 KY Primary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 47504 KY

Addresses

Primary practice location

711 Medical Village Dr
Edgewood, KY 41017

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 301-2000

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
I20130715000171 KY Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8426298522 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Advanced Heart Failure and Transplant CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Louisville School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Elizabeth Medical Center, IncGroup PAC ID 0648174623, 187 clinicians

Practice addresses (Care Compare)

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 301-2237

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
R2754KYMDInternal Medicine Physician
47504KYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc Internal Medicine CurrentSince Sep 2, 2019 Accepting new patients
St Elizabeth Medical Center, Inc Internal Medicine CurrentSince Sep 2, 2019 Accepting new patients
St Elizabeth Medical Center, Inc CurrentSince Sep 2, 2019 Accepting new patients
Summit Medical Group, Inc. CurrentSince Sep 2, 2019 Accepting new patients

Locations

1500 James Simpson Jr Way
Covington, KY 41011
Phone (859) 655-4353

1500 James Simpson Jr Way
Ste 2
Covington, KY 41011

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

711 Medical Village Dr
Edgewood, KY 41017
Phone (859) 287-3045

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

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

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

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": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1922397363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-301-2000",
            "fax_number": "859-426-4140"
        },
        {
            "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": "41017",
            "telephone_number": "859-331-0774",
            "fax_number": "859-578-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOTRA",
        "first_name": "AMANINDERAPAL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-06",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "47504",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "R2754",
            "primary": false
        },
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "KY",
            "license": "47504",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "47504",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.