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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. WILLIAM BRIAN HELTON MD
NPI 1174786115
Otolaryngology in Prestonsburg, KY

Active since July 09, 2008PECOS Enrolled
86.86/100
CMS Quality Rating
5322 KY ROUTE 321, PRESTONSBURG, KY 41653(606) 886-2712(606) 886-2713 Get Directions Write a Review

NPPES record last updated: July 30, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 30, 2026, Jun 4, 2026, Jul 12, 2022 and 3 more (6 updates tracked since 2019).

About Dr. William Brian Helton Md NPPES

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

DR. WILLIAM BRIAN HELTON MD (NPI 1174786115) is an individual otolaryngology provider in Prestonsburg, Kentucky, licensed in Kentucky (43550) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS, is affiliated with Highlands Arh Regional Medical Center, and is a graduate of University Of Louisville School Of Medicine (2006).

NPPES Registry Identity

NPI1174786115
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameDR. WILLIAM BRIAN HELTONCredential: MD
Location Address5322 KY ROUTE 321Prestonsburg, KY 41653-9114
Mailing Address5322 Ky Route 321Prestonsburg, KY 41653-9114 · (606) 886-2712 · Fax (606) 886-2713
Phone(606) 886-2712
Fax(606) 886-2713
Sole ProprietorNo
Medical School CMSUniversity Of Louisville School Of MedicineGraduated 2006
Enumeration DateJuly 9, 2008
Last NPPES UpdateJuly 30, 20266 updates tracked since enumeration
NPPES CertifiedJuly 30, 2026
✔ NPI 1174786115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in KY · 43550
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.
5322 KY ROUTE 321, Prestonsburg, KY 41653
Open in Google Maps ↗

Other Identifiers 1

Medicaid7100134900KY

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. William Brian Helton 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 ID5597898387
PECOS Enrollment IDI20100730000293
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 16

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.
282 services174 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.
129 services12 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.
110 services110 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.
90 services63 patients
Destruction of precancer skin growth, 2-14 growths 17003
This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
67 services15 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.
61 services51 patients

Hospital Affiliations CMS Care Compare 5

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

Highlands Arh Regional Medical Center

Acute Care Hospitals · Prestonsburg, KY
2/5 CMS rating
OwnershipProprietary
CMS Certification Number180005
Location5000 Kentucky Route 321Prestonsburg, KY 41653 · Floyd County
Emergency services Birthing friendly

Hazard Arh Regional Medical Center

Acute Care Hospitals · Hazard, KY
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180029
Location100 Medical Center DriveHazard, KY 41701 · Perry County
Emergency services Birthing friendly

Pikeville Medical Center

Acute Care Hospitals · Pikeville, KY
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180044
Location911 Bypass RoadPikeville, KY 41501 · Pike County
Emergency services Birthing friendly

Paul B Hall Regional Medical Center

Acute Care Hospitals · Paintsville, KY
1/5 CMS rating
OwnershipProprietary
CMS Certification Number180078
Location625 James S Trimble BoulevardPaintsville, KY 41240 · Johnson County
Emergency services

Three Rivers Medical Center

Acute Care Hospitals · Louisa, KY
3/5 CMS rating
OwnershipProprietary
CMS Certification Number180128
Location2485 Highway 644Louisa, KY 41230 · Lawrence County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41653 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.

86.86/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality72.39
Promoting Interoperability100
Improvement Activities40
Cost70.65

Reported Quality Measures

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.
100%388 patients5/55-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.
99%215 patients5/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
96%629 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…
76%112 patients4/55-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.
100%179 patients5/55-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%354 patients3/55-star benchmark: 97%
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…
98%2,085 patients5/55-star benchmark: 97%
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: 100% · 107 patients
Patients tobacco: 89% · 1,038 patients
71%69 patients3/55-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…
100%354 patients5/55-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…
27%1,013 patients2/55-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.
8%354 patients
Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.
Patients nutrition: 96% · 456 patients
Patients physicalActivity: 96% · 456 patients
100%456 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.

Other Providers at the Same Location NPPES 5

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

ARH TUG VALLEY HEALTH SERVICES, INC.
Otolaryngology
5322 KY ROUTE 321
PRESTONSBURG, KY 41653
Floyd County (606) 886-2712
KENTUCKY LAPAROSCOPIC & ADVANCED SURGICAL SPECIALISTS, PLLC
Surgery
5322 KY ROUTE 321, SUITE 1
PRESTONSBURG, KY 41653
Floyd County (606) 886-8240
MARK VERONNEAU PLASTICS & ENT, PLLC
Otolaryngology
5322 KY ROUTE 321
PRESTONSBURG, KY 41653
Floyd County (606) 886-2712
DELISA CAUDILL APRN
Nurse Practitioner
5322 KY ROUTE 321
PRESTONSBURG, KY 41653
Floyd County (606) 886-2712
DR. MARK J VERONNEAU DO
Otolaryngology
5322 KY ROUTE 321, SUITE 2
PRESTONSBURG, KY 41653
Floyd County (606) 886-2712

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 William Helton's NPI number?

The NPI number for William Helton is 1174786115. It was assigned to this individual provider in the NPPES registry on July 9, 2008.

Where is William Helton located?

William Helton practices at 5322 Ky Route 321, Prestonsburg, KY 41653. The listed phone number is (606) 886-2712.

What is William Helton's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is William Helton enrolled in Medicare?

Yes. William Helton 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 William Helton accept?

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

According to CMS data, William Helton is affiliated with Highlands Arh Regional Medical Center, Hazard Arh Regional Medical Center, Pikeville Medical Center, Paul B Hall Regional Medical Center and Three Rivers Medical Center.

When was this NPI record last updated?

The NPPES record for William Helton was last updated on July 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days 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.