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DR. DANA PHILLIP EDWARDS M.D.
NPI 1164424131
Surgery in Manchester, KY

Active since August 10, 2005PECOS Enrolled
97.4/100
CMS Quality Rating
204 TOWN BRANCH RD, MANCHESTER, KY 40962(606) 598-8766(606) 598-1903 Get Directions Write a Review

NPPES record last updated: April 26, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Dana Phillip Edwards M.d. NPPES

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

DR. DANA PHILLIP EDWARDS M.D. (NPI 1164424131) is an individual surgery provider in Manchester, Kentucky, licensed in Kentucky (34747) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164424131
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. DANA PHILLIP EDWARDSCredential: M.D.
Location Address204 TOWN BRANCH RDManchester, KY 40962-1322
Mailing Address204 Town Branch RdManchester, KY 40962-1322 · (606) 598-8766 · Fax (606) 598-1903
Phone(606) 598-8766
Fax(606) 598-1903
Sole ProprietorNo
Enumeration DateAugust 10, 2005
Last NPPES UpdateApril 26, 2022
NPPES CertifiedApril 26, 2022
✔ NPI 1164424131 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in KY · 34747
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.
204 TOWN BRANCH RD, Manchester, KY 40962
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Other Identifiers 2

Medicaid64347479KY
Other1164424131KY · Npi

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Dana Phillip Edwards M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

4

Medicare enrollment records show Dana Edwards reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Edwards Clinic, Psc
0.1 mi
Rural Health
204 TOWN BRANCH ROAD
Manchester, KY 40962
  • Reassigned Medicare billing, Kentucky enrollment
  • 3 clinicians in this Medicare group
NPI 1154635407 (606) 598-8766
Family Practice Of Kentucky LLC
0.6 mi
Rural Health
21 CRESTVIEW DR
Manchester, KY 40962
  • Reassigned Medicare billing, Kentucky enrollment
  • 9 clinicians in this Medicare group
NPI 1972979540 (606) 594-1769
Arh Mary Breckinridge Health Services, Inc.
21 mi
Clinic/Center
310 COLLEGE ST
Barbourville, KY 40906
  • Reassigned Medicare billing, Kentucky enrollment
  • 89 clinicians in this Medicare group
NPI 1750991840 (606) 546-1395
Pineville Community Health Center Inc
27 mi
Nurse Anesthetist, Certified Registered
850 RIVERVIEW AVE
Pineville, KY 40977
  • Reassigned Medicare billing, Kentucky enrollment
  • 25 clinicians in this Medicare group
NPI 1275192924 (606) 337-3051

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

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.
16 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40962 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.

97.4/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality76.55
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Biopsy Follow-Up
Percentage of new patients whose biopsy results have been reviewed and communicated to the primary care/referring physician and patient by the performing physician
87%67 patients4/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
40%489 patients2/55-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%1,741 patients4/55-star benchmark: 100%
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
100%135 patients5/55-star benchmark: 100%
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.

Other Providers at the Same Location NPPES 2

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

ERICA BRIGHT
Case Manager/Care Coordinator
204 TOWN BRANCH RD
MANCHESTER, KY 40962
Clay County (606) 598-8766
MRS. EVA ANGEL EDWARDS APRN,FNP-BC,RFNA,CNO
Nurse Practitioner (Family)
204 TOWN BRANCH RD
MANCHESTER, KY 40962
Clay County (606) 598-8766

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 Dana Edwards's NPI number?

The NPI number for Dana Edwards is 1164424131. It was assigned to this individual provider in the NPPES registry on August 10, 2005.

Where is Dana Edwards located?

Dana Edwards practices at 204 Town Branch Rd, Manchester, KY 40962. The listed phone number is (606) 598-8766.

What is Dana Edwards's specialty?

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

Is Dana Edwards enrolled in Medicare?

Yes. Dana Edwards is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Dana Edwards's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dana Edwards reassigns Medicare benefits to 4 organizations: Edwards Clinic, Psc (Manchester, KY), Family Practice Of Kentucky LLC (Manchester, KY), Arh Mary Breckinridge Health Services, Inc. (Barbourville, KY) and Pineville Community Health Center Inc (Pineville, KY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dana Edwards's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dana Edwards accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee and CareSource list Dana Edwards 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.

When was this NPI record last updated?

The NPPES record for Dana Edwards was last updated on April 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.