LORI M SCALES MD
NPI 1316902109
Internal Medicine in Mt Washington, KY

Q: What is Lori Scales's NPI number?

The NPI number for Lori Scales is 1316902109. It was assigned to this individual provider in the NPPES registry on April 18, 2006. The provider is also known as Lori M Schmidt MD.

Q: What is Lori Scales's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Lori Scales was last updated on October 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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 April 18, 2006PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

300 HIGH POINT CT, MT WASHINGTON, KY 40047(502) 955-6129(502) 955-8161 Get Directions Write a Review

NPPES record last updated: October 28, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 21, 2021, Apr 1, 2016 (2 updates tracked since 2016).

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About Lori M Scales Md NPPES

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

LORI M SCALES MD (NPI 1316902109) is an individual internal medicine provider in Mt Washington, Kentucky, licensed in Kentucky (35852) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS, is affiliated with Jewish Hospital & St Mary's Healthcare, and is a graduate of University Of Louisville School Of Medicine (1999).

NPPES Registry Identity

NPI1316902109

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameLORI M SCALESCredential: MD

Location Address300 HIGH POINT CTMt Washington, KY 40047-6560

Mailing AddressPo Box 776351Chicago, IL 60677-6351 · (502) 588-9490 · Fax (502) 272-5116

Phone(502) 955-6129

Fax(502) 955-8161

Sole ProprietorNo

Medical School CMSUniversity Of Louisville School Of MedicineGraduated 1999

Enumeration DateApril 18, 2006

Last NPPES UpdateOctober 28, 20242 updates tracked since enumeration

NPPES CertifiedOctober 28, 2024

✔ NPI 1316902109 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in KY · 35852

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedPediatricsTaxonomy 208000000X · License 35852 (KY)

300 HIGH POINT CT, Mt Washington, KY 40047

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Other Names 1

Former Name (1)Lori M Schmidt Md

Other Identifiers 9

Other50001529Passport / Nma

Other000000350676Anthem / Nma

Other023067Siho / Nma

Other000052154GHumana / Nma

Other2443114000Passport Advantage / Nma

Medicaid64067580KY

Other1208710Cha / Nma

Other5843355Cigna / Nma

OtherP00176818KY · Railroad Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, 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

Lori M Scales 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 ID5193782308

PECOS Enrollment IDI20041220000136

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 15

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.

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

637 services307 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.

310 services177 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

123 services20 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.

90 services70 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

86 services85 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

80 services79 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

68 services68 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

43 services37 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

24 services21 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

20 services15 patients

Testing for presence of drug, read by direct observation 80305

Testing for the presence of drugs involves collecting a sample, usually urine, which is then analyzed for specific substances. The process is monitored directly to ensure accuracy and integrity. This test helps to confirm if drugs are present in your system.

18 services18 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

14 services14 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

13 services13 patients

Stool analysis for blood, by fecal hemoglobin determination by immunoassay 82274

A stool analysis for blood, or fecal hemoglobin determination by immunoassay, is a test that checks for hidden blood in your stool. This test helps identify potential issues in your digestive system. It involves collecting a small stool sample which is then analyzed in a lab for the presence of blood.

12 services12 patients

Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19) and influenza virus types a and b 87636

This test detects the presence of SARS-CoV-2 (COVID-19) and Influenza types A and B in your body. It uses a method called the multiplex amplified probe technique to amplify and identify specific virus genes. It helps in early diagnosis and appropriate treatment.

12 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Jewish Hospital & St Mary's Healthcare

Acute Care Hospitals · Louisville, KY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180040

Location200 Abraham Flexner WayLouisville, KY 40202 · Jefferson County

Emergency services

Norton Hospitals, Inc

Acute Care Hospitals · Louisville, KY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180088

Location200 East Chestnut StreetLouisville, KY 40202 · Jefferson County

Emergency services Birthing friendly

Baptist Health Louisville

Acute Care Hospitals · Louisville, KY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180130

Location4000 Kresge WayLouisville, KY 40207 · Jefferson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40047 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 Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 10

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

11 suppliers54 claims125 services$6.21 avg. paid by Medicare

Normal, low and high calibrator solution / chips A4256

DME-Other DME · category DE000N

5 suppliers18 claims18 services$2.61 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

11 suppliers43 claims46 services$1.08 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

3 suppliers11 claims65 services$1.68 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers18 claims18 services$13.87 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers30 claims30 services$58.68 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 10

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

MS. LACEY ANNE CONWAY FNP

Nurse Practitioner (Family)

300 HIGH POINT CT
MOUNT WASHINGTON, KY 40047

Bullitt County (502) 955-6129

FIRST UROLOGY, PSC

Urology