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DR. JOSHUA CLAPP M.D.
NPI 1124569454
Surgery in Madisonville, KY

Active since March 20, 2017PECOS EnrolledAccepts Medicare Assignment
800 HOSPITAL DR FL 3, MADISONVILLE, KY 42431(270) 326-4780(270) 326-4804 Get Directions Write a Review

NPPES record last updated: March 14, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 14, 2023, Jun 6, 2022, Mar 20, 2017 (3 updates tracked since 2017).

About Dr. Joshua Clapp M.d. NPPES

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

DR. JOSHUA CLAPP M.D. (NPI 1124569454) is an individual surgery provider in Madisonville, Kentucky, licensed in Kentucky (TP735) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS, is affiliated with Deaconess Henderson Hospital, and is a graduate of University Of Tennessee, Hsc, College Of Medicine (2017).

NPPES Registry Identity

NPI1124569454
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. JOSHUA CLAPPCredential: M.D.
Location Address800 HOSPITAL DR FL 3Madisonville, KY 42431-1658
Mailing Address550 S Jackson St, 2nd Floor Acb Department Of General SurgeryLouisville, KY 40202-1622
Phone(270) 326-4780
Fax(270) 326-4804
Sole ProprietorNo
Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 2017
Enumeration DateMarch 20, 2017
Last NPPES UpdateMarch 14, 20233 updates tracked since enumeration
NPPES CertifiedMarch 14, 2023
✔ NPI 1124569454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in KY · TP735
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
800 HOSPITAL DR FL 3, Madisonville, KY 42431
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.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

Dr. Joshua Clapp 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 ID3678821808
PECOS Enrollment IDI20220712000820
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 9

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.
43 services34 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.
30 services30 patients
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.
25 services17 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
24 services20 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.
23 services23 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.
19 services19 patients

Hospital Affiliations CMS Care Compare 2

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

Deaconess Henderson Hospital

Acute Care Hospitals · Henderson, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number180056
Location1305 N Elm StHenderson, KY 42420 · Henderson County
Emergency services Birthing friendly

Baptist Health Deaconess Madisonville

Acute Care Hospitals · Madisonville, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180093
Location900 Hospital DriveMadisonville, KY 42431 · Hopkins County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 42431 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.

Other Providers at the Same Location NPPES

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

JESSICA BRIDGFORTH APRN
Nurse Practitioner
800 HOSPITAL DR FL 3
MADISONVILLE, KY 42431
Hopkins County (270) 326-5000

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 Joshua Clapp's NPI number?

The NPI number for Joshua Clapp is 1124569454. It was assigned to this individual provider in the NPPES registry on March 20, 2017.

Where is Joshua Clapp located?

Joshua Clapp practices at 800 Hospital Dr Fl 3, Madisonville, KY 42431. The listed phone number is (270) 326-4780.

What is Joshua Clapp's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Joshua Clapp enrolled in Medicare?

Yes. Joshua Clapp 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 Joshua Clapp accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health and Ambetter of Tennessee list Joshua Clapp 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 Joshua Clapp affiliated with any hospitals?

According to CMS data, Joshua Clapp is affiliated with Deaconess Henderson Hospital and Baptist Health Deaconess Madisonville.

When was this NPI record last updated?

The NPPES record for Joshua Clapp was last updated on March 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.