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MARY RACHEL MCGUFFEY M.D.
NPI 1235157645
Pediatrics in Lexington, KY

Active since July 17, 2006PECOS Enrolled
80.89/100
CMS Quality Rating
120 N EAGLE CREEK DR, SUITE 250, LEXINGTON, KY 40509(859) 258-5141(859) 258-5168 Get Directions Write a Review

NPPES record last updated: November 2, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mary Rachel Mcguffey M.d. NPPES

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

MARY RACHEL MCGUFFEY M.D. (NPI 1235157645) is an individual pediatrics provider in Lexington, Kentucky, licensed in Kentucky (36721) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235157645
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameMARY RACHEL MCGUFFEYCredential: M.D.
Location Address120 N EAGLE CREEK DR, SUITE 250Lexington, KY 40509-1827
Mailing Address120 N Eagle Creek Dr, Suite 250Lexington, KY 40509-1827 · (859) 258-5141 · Fax (859) 258-5168
Phone(859) 258-5141
Fax(859) 258-5168
Sole ProprietorNo
Enumeration DateJuly 17, 2006
Last NPPES UpdateNovember 2, 2007
✔ NPI 1235157645 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in KY · 36721
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
120 N EAGLE CREEK DR, Lexington, KY 40509
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Other Names 1

Former Name (1)Mary Rachel Chamberlain M.d.

Other Identifiers 6

OtherCB5773Rr Medicare Group
Other4000501KY · Medicare Lab Group
Medicare ID-Type Unspecified0787004KY
Medicare UPINH41592
Other37903705KY · Medicaid Lab Group
Medicaid64034846KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Rachel Mcguffey 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 Reassignment

Medicare enrollment records show Mary Mcguffey reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

New Lexington Clinic, Psc
Same address
Podiatrist
100 N EAGLE CREEK DR
Lexington, KY 40509
  • Reassigned Medicare billing, Kentucky enrollment
  • 338 clinicians in this Medicare group
NPI 1821283011 (859) 258-5200

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40509 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
$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.

80.89/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality62.29
Promoting Interoperability100
Improvement Activities40
Cost74

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.
96%85 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.
99%2,570 patients5/55-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…
21%146 patients1/55-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.
97%107 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.
81%2,186 patients4/55-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…
42%76 patients2/55-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
45%599 patients2/55-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: 96% · 28 patients
86%28 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…
82%2,186 patients4/55-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…
93%2,186 patients5/55-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.
40%2,186 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 20

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

PALAK B WALL MD PLLC
Ophthalmology
120 N EAGLE CREEK DR
LEXINGTON, KY 40509
Fayette County (614) 565-6088
M2K INTERNAL MEDICINE, PSC
Internal Medicine
120 N EAGLE CREEK DR, SUITE 321
LEXINGTON, KY 40509
Fayette County (859) 233-1490
DR. KACI M WATHEN AUD
Audiologist-Hearing Aid Fitter
120 N EAGLE CREEK DR
LEXINGTON, KY 40509
Fayette County (859) 629-7140
SAINT JOSEPH MEDICAL FOUNDATION, INC
Internal Medicine (Pulmonary Disease)
120 N EAGLE CREEK DR, SUITE 350
LEXINGTON, KY 40509
Fayette County (859) 967-5648
GERALD W. ELLIOTT M.D.
Dermatology
120 N EAGLE CREEK DR, SUITE 360
LEXINGTON, KY 40509
Fayette County (859) 258-5270
BELINDA L SHIRKEY M.D.
Ophthalmology (Retina Specialist)
120 N EAGLE CREEK DR, STE 500
LEXINGTON, KY 40509
Fayette County (859) 263-3900
DR. WILLIAM J. WOOD M.D.
Ophthalmology (Retina Specialist)
120 N EAGLE CREEK DR, STE 500
LEXINGTON, KY 40509
Fayette County (859) 263-3900
DR. ROBERT ALLEN BUSCH PHARMD
Pharmacist
120 N EAGLE CREEK DR
LEXINGTON, KY 40509
Fayette County (859) 967-5923

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 Mary Mcguffey's NPI number?

The NPI number for Mary Mcguffey is 1235157645. It was assigned to this individual provider in the NPPES registry on July 17, 2006. The provider is also known as Mary Rachel Chamberlain M.D..

Where is Mary Mcguffey located?

Mary Mcguffey practices at 120 N Eagle Creek Dr Suite 250, Lexington, KY 40509. The listed phone number is (859) 258-5141.

What is Mary Mcguffey's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Mary Mcguffey enrolled in Medicare?

Yes. Mary Mcguffey is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mary Mcguffey's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Mcguffey reassigns Medicare benefits to New Lexington Clinic, Psc (Lexington, KY). The 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 Mary Mcguffey's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mary Mcguffey accept?

Health plans from Anthem Blue Cross and Blue Shield list Mary Mcguffey 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 Mary Mcguffey was last updated on November 2, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.