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RALEIGH O JONES JR MD
NPI 1356439889
Otolaryngology in Lexington, KY

Active since October 10, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
740 S LIMESTONE C300, LEXINGTON, KY 40536(859) 257-5405 Get Directions Write a Review

NPPES record last updated: September 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 22, 2020, Aug 9, 2016 (2 updates tracked since 2016).

About Raleigh O Jones Jr Md NPPES

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

RALEIGH O JONES JR MD (NPI 1356439889) is an individual otolaryngology provider in Lexington, Kentucky, licensed in Kentucky (21416) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with St Claire Regional Medical Center, and is a graduate of University Of Kentucky College Of Medicine (1980).

NPPES Registry Identity

NPI1356439889
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameRALEIGH O JONES JRCredential: MD
Location Address740 S LIMESTONE C300Lexington, KY 40536-0001
Mailing Address740 South Limestone E300eLexington, KY 40536-0284 · (859) 257-5405 · Fax (859) 257-5096
Phone(859) 257-5405
Sole ProprietorNo
Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 1980
Enumeration DateOctober 10, 2006
Last NPPES UpdateSeptember 22, 20202 updates tracked since enumeration
NPPES CertifiedSeptember 22, 2020
✔ NPI 1356439889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in KY · 21416
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
740 S LIMESTONE C300, Lexington, KY 40536
Open in Google Maps ↗

Other Identifiers 1

Medicaid64214166KY

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

Raleigh O Jones Jr 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 ID4486683224
PECOS Enrollment IDI20050811000559
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 6

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.

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.
197 services151 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
140 services140 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
69 services59 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.
36 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.
17 services17 patients
Simple removal of skin debris and drainage of mastoid cavity 69220
This procedure involves clearing out skin debris and draining fluid from the mastoid cavity, an air-filled space in the skull behind the ear. It's done to relieve discomfort, improve hearing, and prevent complications related to ear infections or other conditions.
14 services12 patients

Hospital Affiliations CMS Care Compare 2

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

St Claire Regional Medical Center

Acute Care Hospitals · Morehead, KY
3/5 CMS rating
OwnershipGovernment - Federal
CMS Certification Number180018
Location222 Medical CircleMorehead, KY 40351 · Rowan County
Emergency services Birthing friendly

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

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
$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
$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.

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 3

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

THEODORA MAIRE BOWMAN AUD
Audiologist
740 S LIMESTONE C300
LEXINGTON, KY 40536
Fayette County (859) 257-3390
JENNIFER B SHINN PHD
Audiologist
740 S LIMESTONE C300
LEXINGTON, KY 40536
Fayette County (859) 257-5405
DANA SZILI AUD
Audiologist
740 S LIMESTONE C300
LEXINGTON, KY 40536
Fayette County (859) 257-3390

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 Raleigh Jones Jr's NPI number?

The NPI number for Raleigh Jones Jr is 1356439889. It was assigned to this individual provider in the NPPES registry on October 10, 2006.

Where is Raleigh Jones Jr located?

Raleigh Jones Jr practices at 740 S Limestone C300, Lexington, KY 40536. The listed phone number is (859) 257-5405.

What is Raleigh Jones Jr's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Raleigh Jones Jr enrolled in Medicare?

Yes. Raleigh Jones Jr 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 Raleigh Jones Jr accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health and Ambetter of Tennessee list Raleigh Jones Jr 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 Raleigh Jones Jr affiliated with any hospitals?

According to CMS data, Raleigh Jones Jr is affiliated with St Claire Regional Medical Center and University Of Kentucky Hospital.

When was this NPI record last updated?

The NPPES record for Raleigh Jones Jr was last updated on September 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.