Individual provider Active NPI

Liza R Varghese, MD

  • Rheumatology Physician
  • Crestview Hills, KY
National Provider Identifier
1952306193
Registry record updated Oct 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
35303 Issued in KY
Practice address
2616 Legends Way
Crestview Hills, KY 41017-2418
Phone
(859) 331-3100
Fax
(859) 331-9147
NPI assigned
Jun 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 35303 KY Primary

Addresses

Primary practice location

2616 Legends Way
Crestview Hills, KY 41017-2418

Mailing address

2616 Legends Way
Crestview Hills, KY 41017-2418
Phone (859) 331-3100

Other identifiers 2

IdentifierTypeStateIssuer
64037039MedicaidKY
660003446OtherKYRR MEDICARE

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
I20100702000160 KY Practitioner - Rheumatology 9830220011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tristate Arthritis and Rheumatology PSCGroup PAC ID 6901858364, 7 clinicians

Practice addresses (Care Compare)

2616 Legends Way
Crestview Hills, KY 41017-2418
Phone (859) 331-3100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.25 of 100Reported as group
Quality
96.82
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35303KYMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tristate Arthritis & Rheumatology PSC Rheumatology CurrentSince Nov 1, 2001 Accepting new patients

Locations

2616 Legends Way
Crestview Hills, KY 41017
Phone (606) 331-3100

Organizations & group practices 1

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 5

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": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381190400000",
    "number": "1952306193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2616 LEGENDS WAY",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410172418",
            "telephone_number": "859-331-3100",
            "fax_number": "859-331-9147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2616 LEGENDS WAY",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410172418",
            "telephone_number": "859-331-3100",
            "fax_number": "859-331-9147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "LIZA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-15",
        "last_updated": "2013-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "KY",
            "license": "35303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64037039",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "660003446",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview Hills, KY

Sources for this page

Verify at the official NPI Registry.