BRIAN T. MUFFLY MD
NPI 1245762996
Orthopaedic Surgery in Lexington, KY

Active since March 31, 2017PECOS EnrolledAccepts Medicare Assignment
92.26/100
CMS Quality Rating
UNIVERSITY OF KENTUCKY 800 ROSE STREET, LEXINGTON, KY 40536(859) 323-2636(859) 257-1561 Get Directions Write a Review

NPPES record last updated: October 3, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 3, 2022, Jun 29, 2018, Mar 31, 2017 (3 updates tracked since 2017).

About Brian T. Muffly Md NPPES

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

BRIAN T. MUFFLY MD (NPI 1245762996) is an individual orthopaedic surgery provider in Lexington, Kentucky, licensed in Georgia (91716) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS, is affiliated with Emory University Hospital, and is a graduate of Wake Forest University School Of Medicine (2018).

NPPES Registry Identity

NPI1245762996
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameBRIAN T. MUFFLYCredential: MD
Location AddressUNIVERSITY OF KENTUCKY 800 ROSE STREETLexington, KY 40536
Mailing Address740 S Limestone, Room K403Lexington, KY 40536-0293 · (859) 218-3044 · Fax (859) 257-1561
Fax(859) 257-1561
Sole ProprietorNo
Medical School CMSWake Forest University School Of MedicineGraduated 2018
Enumeration DateMarch 31, 2017
Last NPPES UpdateOctober 3, 20223 updates tracked since enumeration
NPPES CertifiedOctober 3, 2022
NPI 1245762996 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Licenses Licensed in GA · 91716 Licensed in KY · R4563
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
UNIVERSITY OF KENTUCKY 800 ROSE STREET, Lexington, KY 40536

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

Brian T. Muffly 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 ID8426300468
PECOS Enrollment IDI20220708001186
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 7

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.

X-ray of knee, 4 or more views 73564
An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.
31 services31 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
27 services27 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
23 services20 patients
X-ray of hip, minimum of 4 views 73503
An X-ray of the hip with a minimum of 4 views is a non-invasive procedure that uses a small amount of radiation to produce images of the hip joint from different angles. This helps to diagnose conditions such as fractures, arthritis, or other abnormalities. It's a quick, painless process.
17 services16 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.
14 services13 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
14 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Emory University Hospital

Acute Care Hospitals · Atlanta, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110010
Location1364 Clifton Road, NEAtlanta, GA 30322 · De Kalb County
Emergency services

Emory University Hospital Midtown

Acute Care Hospitals · Atlanta, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110078
Location550 Peachtree Street, NEAtlanta, GA 30308 · Fulton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40536 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.

92.26/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality73.83
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 10

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

Dentist (Oral and Maxillofacial Surgery)
UNIVERSITY OF KENTUCKY 800 ROSE STREET
LEXINGTON, KY 40536
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
UNIVERSITY OF KENTUCKY 800 ROSE STREET
LEXINGTON, KY 40536
Internal Medicine
UNIVERSITY OF KENTUCKY 800 ROSE STREET
LEXINGTON, KY 40536
Obstetrics & Gynecology
UNIVERSITY OF KENTUCKY 800 ROSE STREET
LEXINGTON, KY 40536
Hospitalist
UNIVERSITY OF KENTUCKY 800 ROSE STREET
LEXINGTON, KY 40536
Anesthesiology
UNIVERSITY OF KENTUCKY 800 ROSE STREET
LEXINGTON, KY 40536
Internal Medicine (Cardiovascular Disease)
UNIVERSITY OF KENTUCKY 800 ROSE STREET
LEXINGTON, KY 40536
Dentist (General Practice)
UNIVERSITY OF KENTUCKY 800 ROSE STREET
LEXINGTON, KY 40536

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 Brian Muffly's NPI number?

The NPI number for Brian Muffly is 1245762996. It was assigned to this individual provider in the NPPES registry on March 31, 2017.

Where is Brian Muffly located?

Brian Muffly practices at University Of Kentucky 800 Rose Street, Lexington, KY 40536. The listed phone number is (859) 323-2636.

What is Brian Muffly's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Brian Muffly enrolled in Medicare?

Yes. Brian Muffly 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 Brian Muffly accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Brian Muffly 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 Brian Muffly affiliated with any hospitals?

According to CMS data, Brian Muffly is affiliated with Emory University Hospital and Emory University Hospital Midtown.

When was this NPI record last updated?

The NPPES record for Brian Muffly was last updated on October 3, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.