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

Q: What is Saadeddine Dughman's NPI number?

The NPI number for Saadeddine Dughman is 1265642193. It was assigned to this individual provider in the NPPES registry on May 22, 2007.

Q: What is Saadeddine Dughman's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

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: November 01, 2026.

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

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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

Phone(859) 287-3045

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

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Other Identifiers 1

Medicaid0070254OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource.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

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.

Medicare Billing Reassignments

Medicare enrollment records show Saadeddine Dughman 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.

Same address

Thoracic Surgery (Cardiothoracic Vascular Surgery)

711 MEDICAL VILLAGE DR
Edgewood, KY 41017

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

NPI 1588620868 (859) 301-9010

Summit Medical Group, Inc

3.9 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 18

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.

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

Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist 93458

This procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.

49 services46 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

42 services38 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

37 services37 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

35 services35 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

31 services31 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

31 services31 patients

Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch 92928

This procedure involves placing a small, mesh tube (stent) in your coronary artery to keep it open. A balloon is used to expand the stent and artery, improving blood flow to your heart. It's typically done for a single artery or branch.

27 services21 patients

Ultrasound evaluation of heart blood vessel or graft with review by radiologist, initial vessel 92978

This procedure involves using ultrasound technology to examine the first vessel of your heart or graft. A radiologist will review the images. It's a non-invasive way to check the health of your heart's blood vessels.

22 services17 patients

Ultrasound of heart 93307

An ultrasound of the heart, also known as an echocardiogram, is a non-invasive procedure that uses sound waves to create images of your heart. This test allows your doctor to monitor how your heart and its valves are functioning. It's a safe, painless process that can help diagnose heart conditions.

19 services19 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.

16 services16 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

16 services16 patients

Electrocardiogram (ecg) up to 30 days continuous with symptom monitoring, transmission and review and report by health care professional 93272

An Electrocardiogram (ECG) is a test that records the electrical activity of your heart. For up to 30 days, a device will continuously monitor your heart's rhythm, noting any symptoms. The data is sent to a healthcare professional who reviews it and provides a report on your heart health.

11 services11 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

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

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.

DEANNA LYNNE WINTER CNP

Nurse Practitioner

711 MEDICAL VILLAGE DRIVE
EDGEWOOD, KY 41017

Kenton County (859) 331-3353

LIA VILARDO APRN

Nurse Practitioner

711 MEDICAL VILLAGE DRIVE
EDGEWOOD, KY 41017

Kenton County (859) 287-3045

ANUSHA GOPALKRISHNA SHANBHAG

Internal Medicine (Cardiovascular Disease)

711 MEDICAL VILLAGE DRIVE
EDGEWOOD, KY 41017

Kenton County (859) 287-3045

TONYA WIDENER APRN

Nurse Practitioner

711 MEDICAL VILLAGE DRIVE
EDGEWOOD, KY 41017

Kenton County (859) 331-3353

HASSAN R SALEH MD

Internal Medicine (Interventional Cardiology)

711 MEDICAL VILLAGE DRIVE, INTERNAL MEDICINE
EDGEWOOD, KY 41017

Kenton County (859) 287-3045

DR. AMIT SRIVASTAVA M.D.

Internal Medicine (Interventional Cardiology)

711 MEDICAL VILLAGE DRIVE
EDGEWOOD, KY 41017

Kenton County (859) 287-3045

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 Saadeddine Dughman's NPI number?

The NPI number for Saadeddine Dughman is 1265642193. It was assigned to this individual provider in the NPPES registry on May 22, 2007.

Where is Saadeddine Dughman located?

Saadeddine Dughman practices at 711 Medical Village Drive, Edgewood, KY 41017. The listed phone number is (859) 287-3045.

What is Saadeddine Dughman's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Saadeddine Dughman enrolled in Medicare?

Yes. Saadeddine Dughman 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 Saadeddine Dughman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Saadeddine Dughman 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 Saadeddine Dughman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Saadeddine Dughman accept?

Health plans from Anthem Blue Cross and Blue Shield and CareSource list Saadeddine Dughman 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 Saadeddine Dughman affiliated with any hospitals?

According to CMS data, Saadeddine Dughman 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 Saadeddine Dughman was last updated on December 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.