EMILY L SEDGWICK M.D.
NPI 1043200728
Radiology - Diagnostic Radiology in Lexington, KY
NPI Status: Active since October 25, 2005
Contact Information
800 ROSE ST
LEXINGTON, KY
ZIP 40536
Phone: (859) 323-2222
Fax: (859) 323-5090
- Individual
- Female
- Radiology
- Diagnostic Radiology
- Accepts Insurance
- PECOS Enrolled
About EMILY SEDGWICK
This page provides the complete NPI Profile along with additional information for Emily Sedgwick, a provider established in Lexington, Kentucky with a medical specialization in Radiology, focusing in diagnostic radiology . The healthcare provider is registered in the NPI registry with number 1043200728 assigned on October 2005. The practitioner's primary taxonomy code is 2085R0202X with license number TP961 (KY). The provider is registered as an individual and her NPI record was last updated 5 years ago.
- NPI
- 1043200728
- Provider Name
- EMILY L SEDGWICK M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 800 ROSE ST LEXINGTON, KY 40536
- Location Phone
- (859) 323-2222
- Location Fax
- (859) 323-5090
- Mailing Address
- PO BOX 4346 DEPT 488 HOUSTON, TX 77210
- Mailing Phone
- (713) 331-1850
- Mailing Fax
- (859) 323-5090
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-25-2005
- Last Update Date
- 03-29-2021
- Code Navigator
Location Map
Secondary Locations
- 12951 South Fwy
Houston, TX 77047
(713) 526-5771
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Radiology Diagnostic Radiology
- Taxonomy Code
- 2085R0202X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- TP961
- License State
- KY
- Taxonomy Description
- A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | L7171 (TX) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- Blue Advantage Plus Gold? 803 - POS
- Blue Advantage Plus Gold? Standard - POS
- Blue Advantage Plus Silver? 202 - POS
- Blue Advantage Plus Silver? 605 - POS
- Blue Advantage Plus Silver? Standard - POS
- Blue Advantage Security HMO? 200 - HMO
- Blue Advantage Silver HMO? 205 - HMO
- Blue Advantage Silver HMO? 801 - HMO
- Blue Advantage Silver HMO? Standard - HMO
- MyBlue Health Bronze? 402 - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 159347701 | MEDICAID (05) | TX |
Medicare Participation & PECOS Enrollment Status
Emily Sedgwick is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 40536 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $82.24
- Minimum New Patient Price $52.76
- Maximum New Patient Price $162.27
- Average New Patient Copayment $20.56
- Minimum New Patient Copayment $13.19
- Maximum New Patient Copayment $40.56
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $66.24
- Minimum Established Patient Price $16.53
- Maximum Established Patient Price $131.99
- Average Established Patient Copayment $16.56
- Minimum Established Patient Copayment $4.13
- Maximum Established Patient Copayment $32.99
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1043200728, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 52 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
LEXINGTON, KY 40536
LEXINGTON, KY 40536
LEXINGTON, KY 40536
LEXINGTON, KY 40536
LEXINGTON, KY 40536
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1043200728, enumerated as an "individual" on October 25, 2005.
The provider is located at 800 ROSE ST LEXINGTON, KY 40536 and the phone number is (859) 323-2222.
Radiology with taxonomy code 2085R0202X and a focus in Diagnostic Radiology.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas, Medicare and. Please consult your insurance carrier or call the provider to verify.
