MR. JUSTIN CLAY PENTICUFF
NPI 1134515083
Urology in Lexington, KY

Q: What is Justin Penticuff's NPI number?

The NPI number for Justin Penticuff is 1134515083. It was assigned to this individual provider in the NPPES registry on April 7, 2015.

Q: What is Justin Penticuff's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Justin Penticuff was last updated on July 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since April 07, 2015PECOS EnrolledAccepts Medicare Assignment

95.5/100

CMS Quality Rating

810 CHERYL LN, LEXINGTON, KY 40504(859) 749-0248 Get Directions Write a Review

NPPES record last updated: July 6, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

On this page

About Mr. Justin Clay Penticuff NPPES

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

MR. JUSTIN CLAY PENTICUFF (NPI 1134515083) is an individual urology provider in Lexington, Kentucky, licensed in Kentucky (55255) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Richmond, and is a graduate of University Of Kentucky College Of Medicine (2016).

NPPES Registry Identity

NPI1134515083

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameMR. JUSTIN CLAY PENTICUFF

Location Address810 CHERYL LNLexington, KY 40504-2318

Mailing Address810 Cheryl LnLexington, KY 40504-2318 · (859) 749-0248

Phone(859) 749-0248

Sole ProprietorYes

Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 2016

Enumeration DateApril 7, 2015

Last NPPES UpdateJuly 6, 2021

NPPES CertifiedJuly 6, 2021

✔ NPI 1134515083 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in KY · 55255

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

810 CHERYL LN, Lexington, KY 40504

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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

Mr. Justin Clay Penticuff 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 ID6901192541

PECOS Enrollment IDI20210716002628

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 22

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 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.

261 services179 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

258 services169 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

198 services130 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.

183 services146 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

86 services86 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.

83 services83 patients

Imaging of urinary tract following injection of a contrast agent 74420

This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.

49 services36 patients

Electronic assessment of bladder emptying 51741

Electronic assessment of bladder emptying is a non-invasive test that measures how well your bladder functions. It uses ultrasound technology to create images of your bladder before and after you use the restroom, helping to identify any issues with bladder emptying.

44 services41 patients

Ultrasound scan of pelvic region through rectum 76872

An ultrasound scan of the pelvic region through the rectum is a medical procedure where a small, smooth device is gently inserted into the rectum. This device uses sound waves to create images of the internal structures in the lower abdomen, aiding in diagnosis and treatment planning.

38 services38 patients

Insertion of stent in ureter using an endoscope 52332

This procedure involves placing a small, flexible tube (stent) in your body's drainage system to help urine flow from the kidneys to the bladder. An endoscope, a thin tube with a light and camera, is used for precise placement.

26 services23 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

26 services24 patients

Diagnostic exam of bladder, urethra, and ureter or kidney using an endoscope 52351

This is a procedure where a small tube with a camera, called an endoscope, is used to examine the bladder and the tubes that carry urine from the kidneys to the bladder. It helps in detecting any abnormalities or issues.

25 services23 patients

Crushing of stone of ureter with insertion of stent using an endoscope 52356

This procedure involves using a thin, flexible tube (endoscope) to locate and break down kidney stones in the ureter. After this, a small tube (stent) is inserted to help maintain an open pathway for urine to flow.

21 services18 patients

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope 52310

This is a procedure to remove an object, stone, or tube from your urinary tract. An endoscope, a thin, flexible tube with a light and camera, is used to locate and remove the object. It is a safe and effective way to address the issue.

20 services19 patients

Ultrasonic guidance for needle placement 76942

Ultrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.

20 services19 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.

18 services18 patients

Simple bladder irrigation and/or instillation 51700

Bladder irrigation and/or instillation is a process where a sterile solution is introduced into the bladder to cleanse it or deliver medication. This procedure helps manage certain bladder conditions, ensuring optimal bladder health.

17 services17 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.

17 services15 patients

Simple insertion of temporary bladder tube 51702

This procedure involves placing a temporary tube into your bladder to help with urine flow. It's done when the body can't naturally remove urine. The tube is inserted through a small opening and allows urine to drain into a bag. It's usually a short-term solution.

14 services11 patients

Biopsy of prostate gland 55700

A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.

11 services11 patients

Biopsy of prostate gland 55700

11 services11 patients

Ultrasonic guidance for needle placement 76942

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Baptist Health Richmond

Acute Care Hospitals · Richmond, KY

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180049

Location801 Eastern BypassRichmond, KY 40475 · Madison County

Emergency services Birthing friendly

Baptist Health Corbin

Acute Care Hospitals · Corbin, KY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180080

LocationOne Trillium WayCorbin, KY 40701 · Whitley County

Emergency services Birthing friendly

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 40504 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

$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.

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

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

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

2 suppliers13 claims1,260 services$1.38 avg. paid by Medicare

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

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 Justin Penticuff's NPI number?

The NPI number for Justin Penticuff is 1134515083. It was assigned to this individual provider in the NPPES registry on April 7, 2015.

Where is Justin Penticuff located?

Justin Penticuff practices at 810 Cheryl Ln, Lexington, KY 40504. The listed phone number is (859) 749-0248.

What is Justin Penticuff's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Justin Penticuff enrolled in Medicare?

Yes. Justin Penticuff 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 Justin Penticuff accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and CareSource list Justin Penticuff 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 Justin Penticuff affiliated with any hospitals?

According to CMS data, Justin Penticuff is affiliated with Baptist Health Richmond, Baptist Health Corbin and Baptist Health Lexington.

When was this NPI record last updated?

The NPPES record for Justin Penticuff was last updated on July 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.