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DR. DONALD J SWIKERT MD
NPI 1700955085
Family Medicine in Edgewood, KY

Active since November 08, 2006PECOS EnrolledAccepts Medicare Assignment
90.38/100
CMS Quality Rating
413 S LOOP RD, EDGEWOOD, KY 41017(859) 301-3800(859) 301-3987 Get Directions Write a Review

NPPES record last updated: January 11, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Donald J Swikert Md NPPES

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

DR. DONALD J SWIKERT MD (NPI 1700955085) is an individual family medicine provider in Edgewood, Kentucky, licensed in Kentucky (19899) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS, is affiliated with St Elizabeth Edgewood, and is a graduate of University Of Louisville School Of Medicine (1977).

NPPES Registry Identity

NPI1700955085
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. DONALD J SWIKERTCredential: MD
Location Address413 S LOOP RDEdgewood, KY 41017-5446
Mailing Address413 S Loop RdEdgewood, KY 41017-5446 · (859) 301-3800 · Fax (859) 301-3987
Phone(859) 301-3800
Fax(859) 301-3987
Sole ProprietorNo
Medical School CMSUniversity Of Louisville School Of MedicineGraduated 1977
Enumeration DateNovember 8, 2006
Last NPPES UpdateJanuary 11, 2019
✔ NPI 1700955085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in KY · 19899
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

413 S LOOP RD, Edgewood, KY 41017
Open in Google Maps ↗

Other Identifiers 2

Medicaid0687494OH
Medicaid64198997KY

Accepted Insurance

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

Dr. Donald J Swikert 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 ID9436289303
PECOS Enrollment IDI20100621000195
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 10

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.

Follow-up hospital inpatient care per day, typically 25 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.
130 services48 patients
Established patient office or other outpatient visit, 30-39 minutes 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.
86 services70 patients
Follow-up hospital inpatient care per day, typically 35 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.
76 services42 patients
Established patient office or other outpatient visit, 20-29 minutes 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.
56 services52 patients
Follow-up nursing facility visit per day, typically 15 minutes 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
51 services21 patients
Initial hospital inpatient care per day, typically 70 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.
50 services49 patients

Hospital Affiliations CMS Care Compare

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

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

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
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

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
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
51%51 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%47 patients4/55-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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6203
DME-Medical/Surgical Supplies · category DA023N
1 supplier12 claims528 services$3.28 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers13 claims13 services$54.54 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

DR. THANESAN GURUMURTHI M.D.
Student in an Organized Health Care Education/Training Program
413 S LOOP RD
EDGEWOOD, KY 41017
Kenton County (859) 301-3800
MARC S CURVIN M.D.
Family Medicine
413 S LOOP RD
EDGEWOOD, KY 41017
Kenton County (859) 301-3841
CARLA SABATINI
Student in an Organized Health Care Education/Training Program
413 S LOOP RD
EDGEWOOD, KY 41017
Kenton County (859) 301-3800
DOUGLAS ALLEN CONNER MD
Family Medicine
413 S LOOP RD, ST ELIZABETH FAMILY PRACTICE CENTER
EDGEWOOD, KY 41017
Kenton County (859) 301-3800
CHRISTOPHER ROBERTSON NYLAND MD
Student in an Organized Health Care Education/Training Program
413 S LOOP RD
EDGEWOOD, KY 41017
Kenton County (859) 301-3800
KARL M SCHMITT M.D.
Family Medicine
413 S LOOP RD
EDGEWOOD, KY 41017
Kenton County (859) 301-3800
DR. LOGAN HAMILTON HICKEY MD
Student in an Organized Health Care Education/Training Program
413 S LOOP RD
EDGEWOOD, KY 41017
Kenton County (859) 301-3800
VIRGINIA PARKER DO
Student in an Organized Health Care Education/Training Program
413 S LOOP RD
EDGEWOOD, KY 41017
Kenton County (859) 301-3800

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 Donald Swikert's NPI number?

The NPI number for Donald Swikert is 1700955085. It was assigned to this individual provider in the NPPES registry on November 8, 2006.

Where is Donald Swikert located?

Donald Swikert practices at 413 S Loop Rd, Edgewood, KY 41017. The listed phone number is (859) 301-3800.

What is Donald Swikert's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Donald Swikert enrolled in Medicare?

Yes. Donald Swikert 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.

What insurance does Donald Swikert accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and CareSource list Donald Swikert 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 Donald Swikert affiliated with any hospitals?

According to CMS data, Donald Swikert is affiliated with St Elizabeth Edgewood.

When was this NPI record last updated?

The NPPES record for Donald Swikert was last updated on January 11, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.