KENNETH D'SOUZA M.D.
NPI 1366896680
Internal Medicine - Pulmonary Disease in Cincinnati, OH

Q: What is Kenneth D'souza's NPI number?

The NPI number for Kenneth D'souza is 1366896680. It was assigned to this individual provider in the NPPES registry on April 22, 2016.

Q: What is Kenneth D'souza's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Kenneth D'souza was last updated on September 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 April 22, 2016PECOS EnrolledAccepts Medicare Assignment

8000 5 MILE RD STE 205, CINCINNATI, OH 45230(513) 233-6480(513) 233-6481 Get Directions Write a Review

NPPES record last updated: September 14, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Kenneth D'souza M.d. NPPES

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

KENNETH D'SOUZA M.D. (NPI 1366896680) is an individual pulmonary disease provider in Cincinnati, Ohio, licensed in Ohio (35.146519) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS, is affiliated with Mercy Health-anderson Hospital, and maintains a secondary practice location in Cincinnati.

NPPES Registry Identity

NPI1366896680

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameKENNETH D'SOUZACredential: M.D.

Location Address8000 5 MILE RD STE 205Cincinnati, OH 45230-2190

Mailing Address8000 5 Mile Rd Ste 205Cincinnati, OH 45230-2190 · (513) 233-6480 · Fax (513) 233-6481

Phone(513) 233-6480

Fax(513) 233-6481

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateApril 22, 2016

Last NPPES UpdateSeptember 14, 2022

NPPES CertifiedSeptember 14, 2022

✔ NPI 1366896680 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in OH · 35.146519

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

8000 5 MILE RD STE 205, Cincinnati, OH 45230

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Secondary Practice Location 1

Location 14777 E Galbraith RdCincinnati, OH 45236-2725 · Phone (513) 686-5446

Accepted Insurance

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

Kenneth D'souza M.d. 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 ID4183000227

PECOS Enrollment IDI20220927003613

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 Reassignment

Medicare enrollment records show Kenneth D'souza reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mercy Health Physicians Cincinnati Specialty Care LLC

9.2 mi

Surgery

4600 MCAULEY PL STE 600
Blue Ash, OH 45242

Reassigned Medicare billing, Ohio enrollment
481 clinicians in this Medicare group

NPI 1154942795 (888) 696-3541

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 15

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.

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

165 services72 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.

159 services121 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

114 services62 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.

111 services66 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.

81 services72 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

57 services57 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

57 services57 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

57 services57 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.

52 services50 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.

40 services40 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.

33 services32 patients

Test for exercise-induced lung stress 94618

An exercise-induced lung stress test assesses how your lungs respond to physical activity. During the test, you'll exercise on a treadmill or stationary bike while your heart rate, breathing, blood pressure, and oxygen levels are monitored. This helps identify any abnormal lung responses to exercise.

29 services28 patients

Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) G0296

This visit involves discussing the necessity of a lung cancer screening using a low dose CT scan. It's a chance to determine if you're eligible for the test and to make an informed decision about proceeding. The scan can potentially detect lung cancer early, improving treatment outcomes.

22 services20 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

21 services21 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

18 services18 patients

Hospital Affiliations CMS Care Compare 3

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

Mercy Health-Anderson Hospital

Acute Care Hospitals · Cincinnati, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360001

Location7500 State RoadCincinnati, OH 45255 · Hamilton County

Emergency services Birthing friendly

Mercy Health - West Hospital

Acute Care Hospitals · Cincinnati, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360234

Location3300 Mercy Health BlvdCincinnati, OH 45211 · Hamilton County

Emergency services Birthing friendly

Mercy Health - Clermont Hospital

Acute Care Hospitals · Batavia, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number360236

Location3000 Hospital DriveBatavia, OH 45103 · Clermont County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45230 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

$126.12 typical visit price

range $54.34 – $166.65

Typical copayment $31.53 (range $13.58 – $41.66)

Most-billed visit code 99204

Established Patient

$96.44 typical visit price

range $17.10 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

Most-billed visit code 99214

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

Other Providers at the Same Location NPPES 2

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

NATHAN ALLAN GORDON MD

Family Medicine

8000 5 MILE RD STE 205
CINCINNATI, OH 45230

Hamilton County (513) 624-1240

DR. VERONICA S POFFEL-MORTON MD

Family Medicine

8000 5 MILE RD STE 205
CINCINNATI, OH 45230

Hamilton County (513) 624-1240

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 Kenneth D'souza's NPI number?

The NPI number for Kenneth D'souza is 1366896680. It was assigned to this individual provider in the NPPES registry on April 22, 2016.

Where is Kenneth D'souza located?

Kenneth D'souza practices at 8000 5 Mile Rd Ste 205, Cincinnati, OH 45230. The listed phone number is (513) 233-6480.

What is Kenneth D'souza's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Kenneth D'souza enrolled in Medicare?

Yes. Kenneth D'souza 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 organization bills Medicare for Kenneth D'souza's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth D'souza reassigns Medicare benefits to Mercy Health Physicians Cincinnati Specialty Care LLC (Blue Ash, OH). The 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 Kenneth D'souza's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kenneth D'souza accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Antidote Health Plan of Ohio, Inc. and CareSource and 4 other insurers list Kenneth D'souza 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 Kenneth D'souza affiliated with any hospitals?

According to CMS data, Kenneth D'souza is affiliated with Mercy Health-Anderson Hospital, Mercy Health - West Hospital and Mercy Health - Clermont Hospital.

When was this NPI record last updated?

The NPPES record for Kenneth D'souza was last updated on September 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.