Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kenneth Bazydlo

Individual provider Family Medicine Physician · NPI 1558854174

Kenneth Bazydlo is a Family Practice in Edgewood, Kentucky. Qualified in 2018, 8 years ago. Practices with St Elizabeth Medical Center, Inc, a 186-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Kentucky and Pennsylvania.

Years since qualifying
8
Licensed in
KY, PA
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

413 S Loop Rd
Edgewood, KY 41017-5446
Phone: (859) 301-3800
Fax: (859) 301-3987
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence TP195 (KY)
Family Medicine Physician Taxonomy 207Q00000X · Licence MT215774 (PA)

Record details

NPI number1558854174
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 8, 2018
Last updated in NPPESJanuary 12, 2026
Certification dateJanuary 12, 2026
Mailing addressPo Box 635283, Cincinnati, OH 45263-5283

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice St Elizabeth Medical Center, Inc — 186 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Edgewood