SAADEDDINE DUGHMAN MD
NPI 1265642193
Internal Medicine - Cardiovascular Disease in Edgewood, KY

Active since May 22, 2007PECOS EnrolledAccepts Medicare Assignment
90.38/100
CMS Quality Rating
711 MEDICAL VILLAGE DRIVE, EDGEWOOD, KY 41017(859) 287-3045(859) 578-3800 Get Directions Write a Review

NPPES record last updated: December 19, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 19, 2025, Nov 1, 2021, Sep 4, 2018 and 4 more (7 updates tracked since 2017).

About Saadeddine Dughman Md NPPES

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

SAADEDDINE DUGHMAN MD (NPI 1265642193) is an individual cardiovascular disease provider in Edgewood, Kentucky, licensed in Kentucky (49677) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with St Elizabeth Dearborn Hospital, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1265642193
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameSAADEDDINE DUGHMANCredential: MD
Location Address711 MEDICAL VILLAGE DRIVEEdgewood, KY 41017
Mailing AddressP.o. Box 636324Cincinnati, OH 45263-6324 · (859) 344-5555 · Fax (859) 344-5552
Fax(859) 578-3800
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateMay 22, 2007
Last NPPES UpdateDecember 19, 20257 updates tracked since enumeration
NPPES CertifiedDecember 19, 2025
NPI 1265642193 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Licenses Licensed in KY · 49677 Licensed in OH · 35.099872
Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Also ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X · License 35.099872 (OH)
711 MEDICAL VILLAGE DRIVE, Edgewood, KY 41017

Other Identifiers 1

Medicaid0070254OH

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Saadeddine Dughman Md 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 ID5496902678
PECOS Enrollment IDI20170414000719, I20210503000823
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.

Areas of Expertise CMS Part B claims 18

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
819 services690 patients
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.
428 services269 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.
251 services137 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
154 services152 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.
97 services96 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.
67 services59 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
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
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
Quality80.76
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
59%133 patients3/55-star benchmark: 100%
Medication Reconciliation Post-Discharge
The percentage of discharges from any inpatient facility (e.g. hospital, skilled nursing facility, or rehabilitation facility) for patients 18 years and older of age seen within 30 days following discharge in the office by the physician, prescribing…
Patients 65+: 100% · 37 patients
100%44 patients
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
81%249 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…
23%292 patients1/55-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
1%228 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.

Nurse Practitioner
711 MEDICAL VILLAGE DRIVE
EDGEWOOD, KY 41017
Nurse Practitioner
711 MEDICAL VILLAGE DRIVE
EDGEWOOD, KY 41017
Internal Medicine (Cardiovascular Disease)
711 MEDICAL VILLAGE DRIVE
EDGEWOOD, KY 41017
Nurse Practitioner
711 MEDICAL VILLAGE DRIVE
EDGEWOOD, KY 41017
Internal Medicine (Interventional Cardiology)
711 MEDICAL VILLAGE DRIVE
EDGEWOOD, KY 41017
Internal Medicine (Interventional Cardiology)
711 MEDICAL VILLAGE DRIVE, INTERNAL MEDICINE
EDGEWOOD, KY 41017

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1265642193, enumerated as an "individual" on May 22, 2007.

The provider is located at 711 MEDICAL VILLAGE DRIVE EDGEWOOD, KY 41017 and the phone number is (859) 287-3045.

Internal Medicine with taxonomy code 207RC0000X and a focus in Cardiovascular Disease.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.

Saadeddine Dughman is affiliated with: ST ELIZABETH DEARBORN HOSPITAL, ST ELIZABETH FT THOMAS, ST ELIZABETH EDGEWOOD, ST ELIZABETH FLORENCE and ST ELIZABETH GRANT.