DR. DOUGLAS B FLORA MD
NPI 1194718916
Internal Medicine - Medical Oncology in Edgewood, KY

Active since August 26, 2005PECOS EnrolledAccepts Medicare Assignment
90.38/100
CMS Quality Rating
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017(859) 301-4000(859) 301-4001 Get Directions Write a Review

NPPES record last updated: October 1, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 1, 2020, Sep 1, 2016 (2 updates tracked since 2016).

About Dr. Douglas B Flora Md NPPES

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

DR. DOUGLAS B FLORA MD (NPI 1194718916) is an individual medical oncology provider in Edgewood, Kentucky, licensed in Kentucky (39400) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with St Elizabeth Ft Thomas, and is a graduate of Ohio State University College Of Medicine (1999).

NPPES Registry Identity

NPI1194718916
Entity TypeIndividualMale
Primary Taxonomy207RX0202X
Provider Legal NameDR. DOUGLAS B FLORACredential: MD
Location Address1 MEDICAL VILLAGE DREdgewood, KY 41017-3403
Mailing Address2300 Chamber Center Dr, Suite 300Lakeside Park, KY 41017-1686 · (859) 301-4000 · Fax (859) 301-4001
Fax(859) 301-4001
Sole ProprietorNo
Medical School CMSOhio State University College Of MedicineGraduated 1999
Enumeration DateAugust 26, 2005
Last NPPES UpdateOctober 1, 20202 updates tracked since enumeration
NPPES CertifiedOctober 1, 2020
NPI 1194718916 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Medical OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RX0202X
License Licensed in KY · 39400
Definition
An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer.
Also ListedInternal Medicine · Hematology & OncologyTaxonomy 207RH0003X · License 39400 (KY), 35081301 (OH)
1 MEDICAL VILLAGE DR, Edgewood, KY 41017

Other Identifiers 3

Medicaid2552312OH
Medicaid64101298KY
Medicaid200515250IN

Accepted 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. Douglas B Flora 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 ID8820037914
PECOS Enrollment IDI20050428000103
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 2

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.
69 services26 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.
37 services25 patients

Hospital Affiliations CMS Care Compare 2

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

St Elizabeth Ft Thomas

Acute Care Hospitals · Fort Thomas, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180001
Location85 North Grand AvenueFort Thomas, KY 41075 · Campbell County
Emergency services

St Elizabeth Edgewood

Acute Care Hospitals · Edgewood, KY
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number180035
Location1 Medical Village DriveEdgewood, KY 41017 · Kenton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41017 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
$162.27 typical visit price
range $52.76 – $162.27
Typical copayment $40.56 (range $13.19 – $40.56)
Most-billed visit code 99205
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
Most-billed visit code 99214
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.

90.38/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.76
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 2

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

Capecitabine, oral, 500 mg J8521
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier21 claims1,988 services$0.62 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
1 supplier16 claims16 services$16.59 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 Anesthetist, Certified Registered
1 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017
Physician Assistant
1 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017
Surgery (Surgical Oncology)
1 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017
Nurse Practitioner
1 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017
Nurse Anesthetist, Certified Registered
1 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017
Emergency Medicine
1 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017
Nurse Anesthetist, Certified Registered
1 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017
Nurse Practitioner
1 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017

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 Douglas Flora's NPI number?

The NPI number for Douglas Flora is 1194718916. It was assigned to this individual provider in the NPPES registry on August 26, 2005.

Where is Douglas Flora located?

Douglas Flora practices at 1 Medical Village Dr, Edgewood, KY 41017. The listed phone number is (859) 301-4000.

What is Douglas Flora's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Medical Oncology, with taxonomy code 207RX0202X.

Is Douglas Flora enrolled in Medicare?

Yes. Douglas Flora 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 Douglas Flora accept?

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

According to CMS data, Douglas Flora is affiliated with St Elizabeth Ft Thomas and St Elizabeth Edgewood.

When was this NPI record last updated?

The NPPES record for Douglas Flora was last updated on October 1, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.