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AMBER DAWN SEXTON DO
NPI 1013412329
Family Medicine in Sandy Hook, KY

Active since March 28, 2018PECOS EnrolledAccepts Medicare Assignment
79.84/100
CMS Quality Rating
390 S KY 7, SANDY HOOK, KY 41171(606) 738-5155(606) 738-5420 Get Directions Write a Review

NPPES record last updated: August 6, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 6, 2021, Jul 15, 2021, Mar 28, 2018 (3 updates tracked since 2018).

About Amber Dawn Sexton Do NPPES

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

AMBER DAWN SEXTON DO (NPI 1013412329) is an individual family medicine provider in Sandy Hook, Kentucky, licensed in Kentucky (04999) and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS, is affiliated with St Claire Regional Medical Center, and maintains a secondary practice location in Morehead.

NPPES Registry Identity

NPI1013412329
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameAMBER DAWN SEXTONCredential: DO
Location Address390 S KY 7Sandy Hook, KY 41171-6830
Mailing Address222 Medical CirMorehead, KY 40351-1179 · (606) 783-6455 · Fax (606) 783-6392
Phone(606) 738-5155
Fax(606) 738-5420
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateMarch 28, 2018
Last NPPES UpdateAugust 6, 20213 updates tracked since enumeration
NPPES CertifiedAugust 6, 2021
✔ NPI 1013412329 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in KY · 04999
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
390 S KY 7, Sandy Hook, KY 41171
Open in Google Maps ↗

Secondary Practice Location 1

Location 1222 Medical CirMorehead, KY 40351-1179 · Phone (606) 783-6500

Other Identifiers 1

Other04999KY · Ky Medical License

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

Amber Dawn Sexton Do 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 ID4981932001
PECOS Enrollment IDI20210720004089
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 4

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.

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.
25 services25 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.
16 services15 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.
14 services14 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.
13 services13 patients

Hospital Affiliations CMS Care Compare

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

St Claire Regional Medical Center

Acute Care Hospitals · Morehead, KY
3/5 CMS rating
OwnershipGovernment - Federal
CMS Certification Number180018
Location222 Medical CircleMorehead, KY 40351 · Rowan County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41171 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.

79.84/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality58.43
Promoting Interoperability84
Improvement Activities40
Cost71.06

Referred Medical Equipment & Supplies CMS DME claims 6

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
5 suppliers29 claims60 services$6.55 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier28 claims28 services$19.74 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers54 claims55 services$6.76 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
1 supplier34 claims34 services$112.35 avg. paid by Medicare
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620
DME-Drugs Administered Through DME · category DG006N
4 suppliers22 claims1,650 services$0.10 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
6 suppliers23 claims23 services$24.91 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 2

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

ELIZABETH JAYDE ISON
Physician Assistant
390 S KY 7
SANDY HOOK, KY 41171
Elliott County (606) 738-5155
WENDY E. LYKINS APRN
Nurse Practitioner (Family)
390 S KY 7
SANDY HOOK, KY 41171
Elliott County (606) 738-5155

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 Amber Sexton's NPI number?

The NPI number for Amber Sexton is 1013412329. It was assigned to this individual provider in the NPPES registry on March 28, 2018.

Where is Amber Sexton located?

Amber Sexton practices at 390 S Ky 7, Sandy Hook, KY 41171. The listed phone number is (606) 738-5155.

What is Amber Sexton's specialty?

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

Is Amber Sexton enrolled in Medicare?

Yes. Amber Sexton 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.

Is Amber Sexton affiliated with any hospitals?

According to CMS data, Amber Sexton is affiliated with St Claire Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Amber Sexton was last updated on August 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.