NPIMap

Individual provider Active NPI

Sanjay Kaul, MD

  • Internal Medicine Physician
  • Brownsville, KY
National Provider Identifier
1992777866
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36833 Issued in KY
Practice address
104 Mohawk St
104 Mohawk Street
Brownsville, KY 42210-9006
Phone
(270) 597-2155
Fax
(270) 597-3811
NPI assigned
Feb 6, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36833 KY Primary

Addresses

Primary practice location

104 Mohawk St
104 Mohawk Street
Brownsville, KY 42210-9006

Mailing address

PO Box 369
Brownsville, KY 42210-0369
Phone (270) 597-2155

Other identifiers 2

IdentifierTypeStateIssuer
65945792MedicaidKY
64030224MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040312000472 KY Practitioner - Internal Medicine 2062301526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
GLK Enterprises, LLCGroup PAC ID 5092711655, 2 clinicians

Practice addresses (Care Compare)

104 Mohawk St
Brownsville, KY 42210-9006
Phone (270) 597-2155

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36833KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
GLK Enterprises, LLC CurrentSince Sep 1, 2006 Accepting new patients
Bowling Green-Warren County Community Hospital Corporation Past Accepting new patients
Edmonson Health Center LLC Past Accepting new patients

Locations

440 High St
Bowling Green, KY 42101
Phone (270) 282-7105

440 High St
#A
Bowling Green, KY 42101
Phone (270) 282-7105

104 Mohawk St
Brownsville, KY 42210
Phone (270) 597-2155

Interoperability endpoints

  • Direct secure messaging: sanjay.kaul@glacecentral.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Edmonson Nursing & Rehabilitation CenterBrownsville, KY, CCN 185401 Skilled nursing facility Adp of the SNF Feb 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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

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": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1992777866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 369",
            "city": "BROWNSVILLE",
            "state": "KY",
            "postal_code": "422100369",
            "telephone_number": "270-597-2155",
            "fax_number": "270-597-3811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MOHAWK ST",
            "address_2": "104 MOHAWK STREET",
            "city": "BROWNSVILLE",
            "state": "KY",
            "postal_code": "422109006",
            "telephone_number": "270-597-2155",
            "fax_number": "270-597-3811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUL",
        "first_name": "SANJAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "36833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65945792",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64030224",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, KY

Sources for this page

Verify at the official NPI Registry.