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TROY LYNN SEDLMEYER M.D.
NPI 1043273642
Family Medicine in Morgantown, WV

Active since April 07, 2006PECOS EnrolledAccepts Medicare Assignment
900 FAIRMONT RD, MORGANTOWN, WV 26501(304) 292-7316(304) 296-4408 Get Directions Write a Review

NPPES record last updated: June 18, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Troy Lynn Sedlmeyer M.d. NPPES

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

TROY LYNN SEDLMEYER M.D. (NPI 1043273642) is an individual family medicine provider in Morgantown, West Virginia, licensed in West Virginia (21396) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS and is a graduate of West Virginia University School Of Medicine (2001).

NPPES Registry Identity

NPI1043273642
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameTROY LYNN SEDLMEYERCredential: M.D.
Location Address900 FAIRMONT RDMorgantown, WV 26501-3847
Mailing Address1197 Van Voorhis RdMorgantown, WV 26505-3478 · (304) 598-2233 · Fax (304) 599-9536
Phone(304) 292-7316
Fax(304) 296-4408
Sole ProprietorNo
Medical School CMSWest Virginia University School Of MedicineGraduated 2001
Enumeration DateApril 7, 2006
Last NPPES UpdateJune 18, 2024
NPPES CertifiedJune 18, 2024
✔ NPI 1043273642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WV · 21396
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.
900 FAIRMONT RD, Morgantown, WV 26501
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Other Identifiers 2

Medicaid1812785000WV
OtherP00444378WV · Railroad Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.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

Troy Lynn Sedlmeyer 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 ID9133105828
PECOS Enrollment IDI20040624001230
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.
72 services58 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
39 services39 patients
Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) 87811
This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.
27 services26 patients
Detection test by immunoassay with direct visual observation for influenza virus 87804
This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.
26 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 26501 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
$83.49 typical visit price
range $53.20 – $164.59
Typical copayment $20.87 (range $13.30 – $41.14)
Most-billed visit code 99203
Established Patient
$94.81 typical visit price
range $16.47 – $133.29
Typical copayment $23.70 (range $4.11 – $33.32)
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.

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report
8%178 patients1/55-star benchmark: 87%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
100%48 patients1/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
100%3,416 patients5/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
0%318 patients1/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
31%3,172 patients2/55-star benchmark: 98%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 343 patients
Patients totalRate: 1% · 343 patients
1%343 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.

Other Providers at the Same Location NPPES 14

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

ANDREW WHITE
Counselor (Addiction (Substance Use Disorder))
900 FAIRMONT RD
WESTOVER, WV 26501
Monongalia County (304) 365-1353
VIRGINIA MAE BREEDLOVE
Case Manager/Care Coordinator
900 FAIRMONT RD
MORGANTOWN, WV 26501
Monongalia County (304) 381-5381
RACHEL GUIDA
Internal Medicine (Addiction Medicine)
900 FAIRMONT RD
MORGANTOWN, WV 26501
Monongalia County (304) 381-5381
LOWELL HUMPHREYS
Behavior Technician
900 FAIRMONT RD
MORGANTOWN, WV 26501
Monongalia County (304) 381-5381
BARBARA ANNE REGAN PA-C
Physician Assistant (Medical)
900 FAIRMONT RD
WESTOVER, WV 26501
Monongalia County (304) 292-7316
WESTOVER PROJECT ASSOCIATES LLC
Substance Abuse Rehabilitation Facility
900 FAIRMONT RD
MORGANTOWN, WV 26501
Monongalia County (304) 503-3448
SHASTA ANNE BELL MS THERAPIST
Counselor (Addiction (Substance Use Disorder))
900 FAIRMONT RD
MORGANTOWN, WV 26501
Monongalia County (304) 381-5381
JESSICA PEKALA
Registered Nurse (Addiction (Substance Use Disorder))
900 FAIRMONT RD
MORGANTOWN, WV 26501
Monongalia County (304) 381-5381

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 Troy Sedlmeyer's NPI number?

The NPI number for Troy Sedlmeyer is 1043273642. It was assigned to this individual provider in the NPPES registry on April 7, 2006.

Where is Troy Sedlmeyer located?

Troy Sedlmeyer practices at 900 Fairmont Rd, Morgantown, WV 26501. The listed phone number is (304) 292-7316.

What is Troy Sedlmeyer's specialty?

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

Is Troy Sedlmeyer enrolled in Medicare?

Yes. Troy Sedlmeyer 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 Troy Sedlmeyer accept?

Health plans from CareSource list Troy Sedlmeyer 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.

When was this NPI record last updated?

The NPPES record for Troy Sedlmeyer was last updated on June 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.