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

Q: 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.

Q: What is Brian Muffly's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Brian Muffly was last updated on October 3, 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.

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: October 18, 2026.

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

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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

Phone(859) 323-2636

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

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama 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 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.

Medicare Billing Reassignment

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

The Emory Clinic Inc

292 mi

Internal Medicine

1365 CLIFTON RD NE
Atlanta, GA 30322

Reassigned Medicare billing, Georgia enrollment
4,840 clinicians in this Medicare group

NPI 1396798229 (404) 778-2144

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 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 3

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

Saint Joseph's Hospital Of Atlanta, Inc

Acute Care Hospitals · Atlanta, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110082

Location5665 Peachtree Dunwoody RoadAtlanta, GA 30342 · Fulton County

Emergency services

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

Quality

73.83

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 9

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

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