DR. EDWARD H CALDWELL D.O.
NPI 1164757951
Surgery - Vascular Surgery in Edgewood, KY

Q: What is Edward Caldwell's NPI number?

The NPI number for Edward Caldwell is 1164757951. It was assigned to this individual provider in the NPPES registry on October 12, 2009.

Q: What is Edward Caldwell's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Q: When was this NPI record last updated?

The NPPES record for Edward Caldwell was last updated on September 14, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 12, 2009PECOS EnrolledAccepts Medicare Assignment

90.38/100

CMS Quality Rating

580 S LOOP RD, SUITE 201, EDGEWOOD, KY 41017(859) 344-1600(859) 344-0091 Get Directions Write a Review

NPPES record last updated: September 14, 2018. Verified against the NPPES registry weekly; last sync: November 08, 2026.

On this page

About Dr. Edward H Caldwell D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. EDWARD H CALDWELL D.O. (NPI 1164757951) is an individual vascular surgery provider in Edgewood, Kentucky, licensed in Kentucky (03950) and active in the NPI registry since October 2009. He is enrolled in Medicare PECOS, is affiliated with St Elizabeth Dearborn Hospital, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1164757951

Entity TypeIndividualMale

Primary Taxonomy2086S0129X

Provider Legal NameDR. EDWARD H CALDWELLCredential: D.O.

Location Address580 S LOOP RD, SUITE 201Edgewood, KY 41017-3415

Mailing AddressPo Box 635283Cincinnati, OH 45263-5283 · (859) 344-1600 · Fax (859) 344-0091

Phone(859) 344-1600

Fax(859) 344-0091

Sole ProprietorYes

Medical School CMSOtherGraduated 2009

Enumeration DateOctober 12, 2009

Last NPPES UpdateSeptember 14, 2018

✔ NPI 1164757951 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Vascular SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0129X

License✔ Licensed in KY · 03950

Definition

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

580 S LOOP RD, Edgewood, KY 41017

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Edward H Caldwell D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1850539842

PECOS Enrollment IDI20160727000160, I20221018002477

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Edward Caldwell reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

St. Elizabeth Medical Center, Inc.

0.3 mi

Family Medicine

413 S LOOP RD
Edgewood, KY 41017

Reassigned Medicare billing, Kentucky enrollment
275 clinicians in this Medicare group

NPI 1710001185 (859) 301-3800

Summit Medical Group, Inc

4.0 mi

Psychiatry

1360 DOLWICK DRIVE
Erlanger, KY 41018

Reassigned Medicare billing, Indiana and Kentucky enrollments
246 clinicians in this Medicare group

NPI 1508287640 (859) 344-5555

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 25

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

158 services128 patients

Ultrasound of both sides of head and neck blood flow 93880

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

150 services149 patients

Ultrasound study of one arm or leg veins with compression and maneuvers 93971

This is a non-invasive procedure using sound waves to visualize veins in an arm or leg. It involves applying gentle pressure and performing certain movements. It helps identify any abnormal blood flow or clots, ensuring vascular health.

116 services112 patients

Removal of muscle and/or tissue, 20.0 sq cm or less 11043

This procedure involves the surgical removal of a specified area (20.0 sq cm or less) of muscle and/or tissue. It's typically done to treat conditions like tumors, infections, or injuries. Local or general anesthesia ensures comfort. Recovery time varies.

87 services11 patients

Ultrasound study of arm or leg veins with compression and maneuvers 93970

An ultrasound study of arm or leg veins with compression and maneuvers is a non-invasive procedure that uses sound waves to create images of your veins. This helps identify blood clots or other vein problems. During the procedure, pressure is applied to the veins and certain movements are performed to assess blood flow.

85 services82 patients

Ultrasound of leg arteries or artery grafts 93925

An ultrasound of leg arteries or artery grafts is a non-invasive imaging test. It uses high-frequency sound waves to capture live images from inside your body, specifically your leg arteries or grafts. This helps in detecting any blockages or abnormalities.

77 services76 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

68 services64 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

58 services58 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

56 services36 patients

Removal of skin and tissue, 20.0 sq cm or less 11042

This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.

54 services19 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

54 services41 patients

Ultrasonic guidance for blood vessel access 76937

Ultrasonic guidance for blood vessel access is a medical procedure where sound waves are used to create images of your blood vessels. This helps doctors to accurately locate and access the vessels for treatments or tests, ensuring safety and precision.

49 services43 patients

Ultrasound of both sides of head and neck blood flow 93880

38 services38 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

37 services16 patients

Review by radiologist of abdominal aorta image 75625

This is a procedure where a radiologist, a doctor specialized in medical imaging, examines an image of your abdominal aorta. The abdominal aorta is the large blood vessel that carries blood to your lower body. The radiologist checks for any abnormalities to ensure your overall vascular health.

31 services29 patients

Review by radiologist of both arms or legs arteries image 75716

This procedure involves a radiologist examining images of your arm or leg arteries. These images help identify any blockages or abnormalities in the blood vessels that could affect circulation. It's a vital step in diagnosing conditions related to blood flow.

31 services29 patients

Smoking and tobacco use intensive counseling, 4-10 minutes 99406

This service provides brief, intensive counseling (4-10 minutes) to support you in quitting smoking or tobacco use. It involves discussing the risks of tobacco use, benefits of quitting, and strategies to help you stop. It's a critical step towards a healthier lifestyle.

31 services24 patients

Ultrasound of one leg arteries or artery grafts 93926

An ultrasound of leg arteries or artery grafts is a non-invasive test using sound waves to create images of your blood vessels. This helps doctors assess blood flow, identify blockages, and monitor the health of grafts.

28 services28 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

24 services21 patients

Balloon dilation of artery of leg 37224

Balloon dilation of the leg artery is a procedure to improve blood flow. A tiny balloon is inserted into a narrowed artery, then inflated to widen the artery. This helps increase blood circulation to the leg. It's usually done under local anesthesia.

23 services16 patients

Balloon dilation of artery of leg, initial vessel 37228

Balloon dilation of the artery of the leg is a procedure to improve blood flow. A small balloon is inserted into the leg artery and inflated to widen the vessel, allowing better circulation. This is typically the first vessel treated.

21 services18 patients

Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts 93978

This procedure involves using sound waves to create images of your aorta, vena cava, groin vessels, or bypass grafts. It helps to detect abnormalities or blockages, ensuring your blood flows smoothly. It's painless and non-invasive.

20 services20 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

14 services14 patients

Complete ultrasound of abdomen and pelvis artery and vein blood flow 93975

This procedure uses sound waves to create images of your abdomen and pelvis, specifically focusing on the arteries and veins. It helps in assessing the blood flow and detecting any abnormalities, ensuring your overall well-being.

13 services13 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

13 services13 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Elizabeth Dearborn Hospital

Acute Care Hospitals · Lawrenceburg, IN

5/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number150086

Location600 Wilson Creek RdLawrenceburg, IN 47025 · Dearborn County

Emergency services Birthing friendly

St Elizabeth Ft Thomas

Acute Care Hospitals · Fort Thomas, KY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180001

Location85 North Grand AvenueFort Thomas, KY 41075 · Campbell County

Emergency services

St Elizabeth Edgewood

Acute Care Hospitals · Edgewood, KY

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number180035

Location1 Medical Village DriveEdgewood, KY 41017 · Kenton County

Emergency services Birthing friendly

St Elizabeth Florence

Acute Care Hospitals · Florence, KY

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180045

Location4900 Houston RoadFlorence, KY 41042 · Boone County

Emergency services

St Elizabeth Grant

Critical Access Hospitals · Williamstown, KY

OwnershipVoluntary non-profit - Church

CMS Certification Number181311

Location238 Barnes RoadWilliamstown, KY 41097 · Grant County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41017 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$66.24 typical visit price

range $16.53 – $131.99

Typical copayment $16.56 (range $4.13 – $32.99)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

90.38/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

80.76

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

68%120 patients3/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

91%226 patients4/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

28%269 patients2/55-star benchmark: 100%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen

0%229 patients1/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERIN ROLFES OD, MS

Optometrist

580 S LOOP RD
EDGEWOOD, KY 41017

Kenton County (859) 331-9000

CEI PHYSICIANS PSC LLC

Ophthalmology

580 S LOOP RD, SUITE 200
EDGEWOOD, KY 41017

Kenton County (859) 331-9000

DR. ROBERT L STRAWN MD

Ophthalmology

580 S LOOP RD, SUITE 200
EDGEWOOD, KY 41017

Kenton County (513) 984-5133

DR. BARRY L DICK MD

Surgery (Vascular Surgery)

580 S LOOP RD, SUITE 201
EDGEWOOD, KY 41017

Kenton County (859) 344-1600

PETER DAVID GOODWIN MD

Emergency Medicine

580 S LOOP RD
EDGEWOOD, KY 41017

Kenton County (859) 301-6000

DR. EDWARD J HOLLAND MD

Ophthalmology

580 S LOOP RD, SUITE 200
EDGEWOOD, KY 41017

Kenton County (513) 569-3741

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edward Caldwell's NPI number?

The NPI number for Edward Caldwell is 1164757951. It was assigned to this individual provider in the NPPES registry on October 12, 2009.

Where is Edward Caldwell located?

Edward Caldwell practices at 580 S Loop Rd Suite 201, Edgewood, KY 41017. The listed phone number is (859) 344-1600.

What is Edward Caldwell's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Is Edward Caldwell enrolled in Medicare?

Yes. Edward Caldwell is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Edward Caldwell's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Edward Caldwell reassigns Medicare benefits to 2 organizations: St. Elizabeth Medical Center, Inc. (Edgewood, KY) and Summit Medical Group, Inc (Erlanger, KY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Edward Caldwell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Edward Caldwell accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield list Edward Caldwell as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Edward Caldwell affiliated with any hospitals?

According to CMS data, Edward Caldwell is affiliated with St Elizabeth Dearborn Hospital, St Elizabeth Ft Thomas, St Elizabeth Edgewood, St Elizabeth Florence and St Elizabeth Grant.

When was this NPI record last updated?

The NPPES record for Edward Caldwell was last updated on September 14, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.