DONNA CLAY GERHARDSTEIN MD
NPI 1083628978
Internal Medicine - Pulmonary Disease in Lexington, KY

Q: What is Donna Gerhardstein's NPI number?

The NPI number for Donna Gerhardstein is 1083628978. It was assigned to this individual provider in the NPPES registry on July 28, 2006.

Q: What is Donna Gerhardstein's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Active since July 28, 2006PECOS EnrolledAccepts Medicare Assignment

95.5/100

CMS Quality Rating

166 PASADENA DR, LEXINGTON, KY 40503(859) 278-0319(859) 277-9699 Get Directions Write a Review

NPPES record last updated: December 2, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 2, 2020, Jun 6, 2019 (2 updates tracked since 2019).

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About Donna Clay Gerhardstein Md NPPES

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

DONNA CLAY GERHARDSTEIN MD (NPI 1083628978) is an individual pulmonary disease provider in Lexington, Kentucky, licensed in Kentucky (26552) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, is affiliated with Baptist Health Lexington, and is a graduate of University Of Kentucky College Of Medicine (1985).

NPPES Registry Identity

NPI1083628978

Entity TypeIndividualFemale

Primary Taxonomy207RP1001X

Provider Legal NameDONNA CLAY GERHARDSTEINCredential: MD

Location Address166 PASADENA DRLexington, KY 40503-2973

Mailing AddressPo Box 950248Louisville, KY 40295-0248 · (859) 971-4695 · Fax (859) 971-4604

Phone(859) 278-0319

Fax(859) 277-9699

Sole ProprietorNo

Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 1985

Enumeration DateJuly 28, 2006

Last NPPES UpdateDecember 2, 20202 updates tracked since enumeration

NPPES CertifiedDecember 2, 2020

✔ NPI 1083628978 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in KY · 26552

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

166 PASADENA DR, Lexington, KY 40503

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Other Identifiers 1

Medicaid64265523KY

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

Donna Clay Gerhardstein Md 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 ID9638217011

PECOS Enrollment IDI20091104000466

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 15

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

257 services127 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

200 services99 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

165 services100 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.

116 services90 patients

Test to measure expiratory airflow and volume 94010

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

35 services34 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

35 services35 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

35 services35 patients

Test to measure rate of airflow 94375

This test, known as spirometry, measures how much air you can breathe in and out, and how quickly you can do so. It helps assess your lung function and can be used to diagnose or monitor conditions like asthma or COPD.

32 services31 patients

Test to measure expiratory airflow and volume 94010

30 services29 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.

17 services17 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 services12 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

14 services14 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

13 services13 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

11 services11 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Baptist Health Lexington

Acute Care Hospitals · Lexington, KY

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number180103

Location1740 Nicholasville RoadLexington, KY 40503 · Fayette County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40503 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

$122.77 typical visit price

range $52.76 – $162.27

Typical copayment $30.69 (range $13.19 – $40.56)

Most-billed visit code 99204

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.

95.5/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

89.59

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 14

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

Tracheostomy, inner cannula A4623

DME-Orthotic Devices · category DF000N

1 supplier11 claims330 services$5.38 avg. paid by Medicare

Tracheostomy care kit for established tracheostomy A4629

DME-Orthotic Devices · category DF000N

1 supplier11 claims330 services$4.47 avg. paid by Medicare

Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6402

DME-Medical/Surgical Supplies · category DA023N

1 supplier11 claims550 services$0.11 avg. paid by Medicare

Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each A7509

DME-Orthotic Devices · category DF000N

1 supplier11 claims44 services$1.35 avg. paid by Medicare

Tracheostomy tube collar/holder, each A7526

DME-Orthotic Devices · category DF000N

1 supplier11 claims60 services$3.29 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

4 suppliers37 claims37 services$19.38 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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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.

JOSEPH CONRAD MUELLER MD

Internal Medicine (Pulmonary Disease)

166 PASADENA DR, SUITE 100
LEXINGTON, KY 40503

Fayette County (859) 278-0319

JULIE ABNEY APRN

Nurse Practitioner (Family)

166 PASADENA DR, SUITE 100
LEXINGTON, KY 40503

Fayette County (859) 278-0319

MARLANA LYNN KEETON APRN

Nurse Practitioner (Family)

166 PASADENA DR, SUITE 100
LEXINGTON, KY 40503

Fayette County (859) 278-0319

MELANIE HARDIN-PIERCE APRN

Nurse Practitioner (Family)

166 PASADENA DR, SUITE 100
LEXINGTON, KY 40503

Fayette County (859) 278-0319

BAPTIST PHYSICIANS LEXINGTON, INC

Internal Medicine (Pulmonary Disease)

166 PASADENA DR, SUITE 100
LEXINGTON, KY 40503

Fayette County (859) 278-0319

JOHN SYLVESTER HILL MD

Allergy & Immunology

166 PASADENA DR, STE 150
LEXINGTON, KY 40503

Fayette County (859) 276-1452

ALLERGY & ASTHMA PHYSICIANS OF CENTRAL KENTUCKY, PSC

Allergy & Immunology

166 PASADENA DR, SUITE 150
LEXINGTON, KY 40503

Fayette County (859) 276-1452

BAPTIST PHYSICIANS LEXINGTON, INC

Internal Medicine (Pulmonary Disease)

166 PASADENA DR, SUITE 100
LEXINGTON, KY 40503

Fayette County (859) 278-0319

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 Donna Gerhardstein's NPI number?

The NPI number for Donna Gerhardstein is 1083628978. It was assigned to this individual provider in the NPPES registry on July 28, 2006.

Where is Donna Gerhardstein located?

Donna Gerhardstein practices at 166 Pasadena Dr, Lexington, KY 40503. The listed phone number is (859) 278-0319.

What is Donna Gerhardstein's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Donna Gerhardstein enrolled in Medicare?

Yes. Donna Gerhardstein 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 Donna Gerhardstein accept?

Health plans from CareSource list Donna Gerhardstein 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 Donna Gerhardstein affiliated with any hospitals?

According to CMS data, Donna Gerhardstein is affiliated with Baptist Health Lexington.

When was this NPI record last updated?

The NPPES record for Donna Gerhardstein was last updated on December 2, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.