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MICHAEL EDWARD HELM PA-C
NPI 1043461932
Physician Assistant in Somerset, KY

Active since October 09, 2008PECOS EnrolledAccepts Medicare Assignment
85.61/100
CMS Quality Rating
305 LANGDON ST, STE H, SOMERSET, KY 42503(606) 451-2994(606) 451-2975 Get Directions Write a Review

NPPES record last updated: February 19, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Michael Edward Helm Pa-c NPPES

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

MICHAEL EDWARD HELM PA-C (NPI 1043461932) is an individual physician assistant in Somerset, Kentucky, licensed in Kentucky (PA1152) and active in the NPI registry since October 2008. He is enrolled in Medicare PECOS, is affiliated with Wayne County Hospital, and is a graduate of University Of Kentucky College Of Medicine (2008).

NPPES Registry Identity

NPI1043461932
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMICHAEL EDWARD HELMCredential: PA-C
Location Address305 LANGDON ST, STE HSomerset, KY 42503-2750
Mailing Address305 Langdon St, Ste HSomerset, KY 42503-2750 · (606) 451-2994 · Fax (606) 451-2975
Phone(606) 451-2994
Fax(606) 451-2975
Sole ProprietorNo
Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 2008
Enumeration DateOctober 9, 2008
Last NPPES UpdateFebruary 19, 2010
✔ NPI 1043461932 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in KY · PA1152
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
305 LANGDON ST, Somerset, KY 42503
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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

Michael Edward Helm Pa-c 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 ID6103989330
PECOS Enrollment IDI20090114000000
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 5

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.

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.
48 services48 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
39 services30 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
26 services26 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.
19 services17 patients
Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349
An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
15 services15 patients

Hospital Affiliations CMS Care Compare

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

Wayne County Hospital

Critical Access Hospitals · Monticello, KY
OwnershipVoluntary non-profit - Private
CMS Certification Number181321
Location166 Hospital StreetMonticello, KY 42633 · Wayne County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 42503 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
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
Most-billed visit code 99213
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.

85.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality70.25
Improvement Activities40
Cost73.25

Referred Medical Equipment & Supplies CMS DME claims 5

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

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
2 suppliers13 claims13 services$73.02 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
3 suppliers31 claims31 services$21.33 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
3 suppliers25 claims25 services$7.94 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
3 suppliers31 claims31 services$119.59 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
3 suppliers19 claims19 services$22.60 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.

LAKE CUMBERLAND REGIONAL HOSPITAL LLC
Clinic/Center (Rural Health)
305 LANGDON ST
SOMERSET, KY 42503
Pulaski County (606) 679-7441
CAPITAL ANESTHESIA SOLUTIONS OF KENTUCKY LLC
Anesthesiology
305 LANGDON ST
SOMERSET, KY 42503
Pulaski County (330) 618-9944
GAGE KECK DO
Student in an Organized Health Care Education/Training Program
305 LANGDON ST
SOMERSET, KY 42503
Pulaski County (606) 679-7441
LAKE CUMBERLAND SURGICAL ASSISTANTS LLC
Surgery
305 LANGDON ST, LAKE CUMBERLAND REGIONAL HOSP
SOMERSET, KY 42503
Pulaski County (606) 679-7441
ELIZABETH ANN SLAYTON
Student in an Organized Health Care Education/Training Program
305 LANGDON ST
SOMERSET, KY 42503
Pulaski County (502) 220-8534
ELIZABETH ERIN COMBS FNP-C
Neurological Surgery
305 LANGDON ST
SOMERSET, KY 42503
Pulaski County (606) 425-8893
BERNARD WILLIAMS
Emergency Medicine
305 LANGDON ST
SOMERSET, KY 42503
Pulaski County (606) 679-7441
RACHYL LYNN HARMON DO
Student in an Organized Health Care Education/Training Program
305 LANGDON ST
SOMERSET, KY 42503
Pulaski County (606) 813-4050

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 Michael Helm's NPI number?

The NPI number for Michael Helm is 1043461932. It was assigned to this individual provider in the NPPES registry on October 9, 2008.

Where is Michael Helm located?

Michael Helm practices at 305 Langdon St Ste H, Somerset, KY 42503. The listed phone number is (606) 451-2994.

What is Michael Helm's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Michael Helm enrolled in Medicare?

Yes. Michael Helm 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 Michael Helm accept?

Health plans from CareSource list Michael Helm 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 Michael Helm affiliated with any hospitals?

According to CMS data, Michael Helm is affiliated with Wayne County Hospital.

When was this NPI record last updated?

The NPPES record for Michael Helm was last updated on February 19, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.