KENNETH V HUGHES III MD
NPI 1154425411
Otolaryngology in Lexington, KY
Active since September 08, 2006PECOS EnrolledAccepts Medicare Assignment
83.31/100
CMS Quality Rating
About Kenneth V Hughes Iii Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENNETH V HUGHES III MD (NPI 1154425411) is an individual otolaryngology provider in Lexington, Kentucky, licensed in Kentucky (KY30365) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Richmond, and is a graduate of University Of Oklahoma College Of Medicine (1989).
NPPES Registry Identity
NPI1154425411
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameKENNETH V HUGHES IIICredential: MD
Location Address1720 NICHOLASVILLE RD, STE 500Lexington, KY 40503
Mailing Address1720 Nicholasville Rd, Ste 500Lexington, KY 40503 · (859) 278-1114
Phone(859) 278-1114
Sole ProprietorNo
Medical School CMSUniversity Of Oklahoma College Of MedicineGraduated 1989
Enumeration DateSeptember 8, 2006
Last NPPES UpdateMarch 28, 2013
✔ NPI 1154425411 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in KY · KY30365
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
1720 NICHOLASVILLE RD, Lexington, KY 40503
Other Identifiers 5
Medicare PIN0169KY
Medicare PIN0383901KY
Medicare UPINE54300
Medicaid64303654KY
Medicare PIN1503403KY
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
Kenneth V Hughes Iii 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 ID6608769534
PECOS Enrollment IDI20040205000023
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.
192 services161 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.
164 services132 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
134 services106 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.
96 services96 patients
Professional service for multiple injections of allergen 95117
The professional service for multiple injections of allergens involves administering small doses of specific allergens into your body. This is done to help your immune system become less sensitive to them, reducing your allergic reaction over time. It's a safe, effective way to manage allergies.
90 services28 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
60 services50 patients
Hospital Affiliations CMS Care Compare 5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Baptist Health Richmond
Acute Care Hospitals · Richmond, KYOwnershipVoluntary non-profit - Private
CMS Certification Number180049
Location801 Eastern BypassRichmond, KY 40475 · Madison County
Emergency services Birthing friendly
Harrison Memorial Hospital
Acute Care Hospitals · Cynthiana, KYOwnershipVoluntary non-profit - Other
CMS Certification Number180079
Location1210 Ky Hwy 36 ECynthiana, KY 41031 · Harrison County
Emergency services Birthing friendly
Georgetown Community Hospital
Acute Care Hospitals · Georgetown, KYOwnershipProprietary
CMS Certification Number180101
Location1140 Lexington RoadGeorgetown, KY 40324 · Scott County
Emergency services Birthing friendly
Baptist Health Lexington
Acute Care Hospitals · Lexington, KYOwnershipVoluntary non-profit - Other
CMS Certification Number180103
Location1740 Nicholasville RoadLexington, KY 40503 · Fayette County
Emergency services Birthing friendly
Saint Joseph East
Acute Care Hospitals · Lexington, KYOwnershipVoluntary non-profit - Private
CMS Certification Number180143
Location150 North Eagle Creek DriveLexington, KY 40509 · 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
$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.
83.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practiceQuality
85
Promoting Interoperability
100
Improvement Activities
40
Cost
52.71
Reported Quality Measures
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
15%504 patients1/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
16%573 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
19%877 patients1/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
36%50 patients2/55-star benchmark: 100%
Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
48%50 patients2/55-star benchmark: 98%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
68%50 patients3/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
99%2,819 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%1,539 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
36%406 patients2/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
98%825 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
58%3,640 patients3/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
17%707 patients1/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
56%1,779 patients3/55-star benchmark: 97%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
11%1,806 patients1/55-star benchmark: 96%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 99% · 561 patients
Patients tobacco: 56% · 54 patients
89%560 patients4/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
66%3,640 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
83%3,640 patients4/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
35%3,640 patients
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.
Referred Medical Equipment & Supplies CMS DME claims 3
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
4 suppliers12 claims12 services$19.61 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
7 suppliers14 claims66 services$2.79 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
7 suppliers31 claims32 services$44.20 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.
Nurse Practitioner (Acute Care)
1720 NICHOLASVILLE RD, SUITE 506
LEXINGTON, KY 40503
LEXINGTON, KY 40503
Internal Medicine (Infectious Disease)
1720 NICHOLASVILLE RD, SUITE 602
LEXINGTON, KY 40503
LEXINGTON, KY 40503
Internal Medicine (Hospice and Palliative Medicine)
1720 NICHOLASVILLE RD, SUITE 703
LEXINGTON, KY 40503
LEXINGTON, KY 40503
Internal Medicine (Infectious Disease)
1720 NICHOLASVILLE RD, STE 602
LEXINGTON, KY 40503
LEXINGTON, KY 40503
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 Kenneth Hughes's NPI number?
The NPI number for Kenneth Hughes is 1154425411. It was assigned to this individual provider in the NPPES registry on September 8, 2006.
Where is Kenneth Hughes located?
Kenneth Hughes practices at 1720 Nicholasville Rd Ste 500, Lexington, KY 40503. The listed phone number is (859) 278-1114.
What is Kenneth Hughes's specialty?
The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.
Is Kenneth Hughes enrolled in Medicare?
Yes. Kenneth Hughes 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 Kenneth Hughes accept?
Health plans from CareSource list Kenneth Hughes 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 Kenneth Hughes affiliated with any hospitals?
According to CMS data, Kenneth Hughes is affiliated with Baptist Health Richmond, Harrison Memorial Hospital, Georgetown Community Hospital, Baptist Health Lexington and Saint Joseph East.
When was this NPI record last updated?
The NPPES record for Kenneth Hughes was last updated on March 28, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
