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TYLER SIMS MD
NPI 1316479009
Internal Medicine - Nephrology in Lexington, KY

Active since March 31, 2017PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
135 E MAXWELL ST, LEXINGTON, KY 40508(859) 323-2663(859) 257-0260 Get Directions Write a Review

NPPES record last updated: June 8, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jun 8, 2022, Mar 31, 2017 (2 updates tracked since 2017).

About Tyler Sims Md NPPES

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

TYLER SIMS MD (NPI 1316479009) is an individual nephrology provider in Lexington, Kentucky, licensed in Kentucky (54129) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS, is affiliated with University Of Kentucky Hospital, and is a graduate of University Of Mississippi School Of Medicine (2017).

NPPES Registry Identity

NPI1316479009
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameTYLER SIMSCredential: MD
Location Address135 E MAXWELL STLexington, KY 40508-2640
Mailing Address900 S Limestone Ctw 304Lexington, KY 40536-0293 · (859) 323-9918
Phone(859) 323-2663
Fax(859) 257-0260
Sole ProprietorNo
Medical School CMSUniversity Of Mississippi School Of MedicineGraduated 2017
Enumeration DateMarch 31, 2017
Last NPPES UpdateJune 8, 20222 updates tracked since enumeration
NPPES CertifiedJune 8, 2022
✔ NPI 1316479009 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in KY · 54129
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Also ListedInternal MedicineTaxonomy 207R00000X · License R4586 (KY)
135 E MAXWELL ST, Lexington, KY 40508
Open in Google Maps ↗

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

Tyler Sims 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 ID7012265747
PECOS Enrollment IDI20220625000399
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.

Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
80 services15 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
70 services39 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
70 services30 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.
62 services39 patients
Hemodialysis procedure with physician evaluation 90935
Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.
28 services16 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
23 services22 patients

Hospital Affiliations CMS Care Compare 2

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

University Of Kentucky Hospital

Acute Care Hospitals · Lexington, KY
3/5 CMS rating
OwnershipGovernment - State
CMS Certification Number180067
Location800 Rose StreetLexington, KY 40536 · Fayette County
Emergency services Birthing friendly

Baptist Health Lexington

Acute Care Hospitals · Lexington, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number180103
Location1740 Nicholasville RoadLexington, KY 40503 · Fayette County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40508 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
$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.

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

Other Providers at the Same Location NPPES 13

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

DIABETES CARE CENTER OF KENTUCKY
Family Medicine
135 E MAXWELL ST, SUITE 200
LEXINGTON, KY 40508
Fayette County (859) 422-4343
MS. RHODA ADWOBA AKAFUAH MD
Pediatrics
135 E MAXWELL ST, SUITE 200
LEXINGTON, KY 40508
Fayette County (859) 323-6211
ALYSON L PAPE PHARMD
Pharmacist
135 E MAXWELL ST
LEXINGTON, KY 40508
Fayette County (859) 323-2663
BETH ANN MILLER MD
Internal Medicine (Allergy & Immunology)
135 E MAXWELL ST, SUITE 250
LEXINGTON, KY 40508
Fayette County (859) 323-5199
WENDY KATHERINE RAMEY B.S.PHARM, R.PH, CSP
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
135 E MAXWELL ST, SUITE 401
LEXINGTON, KY 40508
Fayette County (859) 218-5418
DR. HENRY GROVER WELLS JR. M.D.
Plastic Surgery
135 E MAXWELL ST, SUITE 402
LEXINGTON, KY 40508
Fayette County (859) 255-6649
PHILIP BRUCE LATHAM MD
Pediatrics
135 E MAXWELL ST, SUITE 200
LEXINGTON, KY 40508
Fayette County (859) 323-6211
MIRIAM BEHAR MD
Pediatrics
135 E MAXWELL ST, STE 200
LEXINGTON, KY 40508
Fayette County (859) 218-0788

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 Tyler Sims's NPI number?

The NPI number for Tyler Sims is 1316479009. It was assigned to this individual provider in the NPPES registry on March 31, 2017.

Where is Tyler Sims located?

Tyler Sims practices at 135 E Maxwell St, Lexington, KY 40508. The listed phone number is (859) 323-2663.

What is Tyler Sims's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Tyler Sims enrolled in Medicare?

Yes. Tyler Sims 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 Tyler Sims accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health and Ambetter of Tennessee list Tyler Sims 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 Tyler Sims affiliated with any hospitals?

According to CMS data, Tyler Sims is affiliated with University Of Kentucky Hospital and Baptist Health Lexington.

When was this NPI record last updated?

The NPPES record for Tyler Sims was last updated on June 8, 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.