DR. JOSHUA KENNETH EDGERTON M.D.
NPI 1366736159
Surgery in Mobile, AL

Q: What is Joshua Edgerton's NPI number?

The NPI number for Joshua Edgerton is 1366736159. It was assigned to this individual provider in the NPPES registry on June 9, 2011.

Q: What is Joshua Edgerton's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for Joshua Edgerton was last updated on November 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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 June 09, 2011PECOS EnrolledAccepts Medicare Assignment

6701 AIRPORT BLVD STE A208, MOBILE, AL 36608(251) 266-3544(251) 266-3543 Get Directions Write a Review

NPPES record last updated: November 6, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 6, 2024, Apr 24, 2017, Aug 24, 2016 (3 updates tracked since 2016).

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About Dr. Joshua Kenneth Edgerton M.d. NPPES

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

DR. JOSHUA KENNETH EDGERTON M.D. (NPI 1366736159) is an individual surgery provider in Mobile, Alabama, licensed in Alabama (MD.49740) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1366736159

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameDR. JOSHUA KENNETH EDGERTONCredential: M.D.

Location Address6701 AIRPORT BLVD STE A208Mobile, AL 36608-3763

Mailing AddressPo Box 36258Belfast, ME 04915-1204 · (251) 318-2678 · Fax (251) 405-9900

Phone(251) 266-3544

Fax(251) 266-3543

Sole ProprietorYes

Medical School CMSOtherGraduated 2011

Enumeration DateJune 9, 2011

Last NPPES UpdateNovember 6, 20243 updates tracked since enumeration

NPPES CertifiedNovember 6, 2024

✔ NPI 1366736159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

Licenses✔ Licensed in AL · MD.49740✔ Licensed in NC · 2016-01821

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

6701 AIRPORT BLVD STE A208, Mobile, AL 36608

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter Health 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

Dr. Joshua Kenneth Edgerton M.d. 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 ID7214216654

PECOS Enrollment IDI20241125002297

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 Reassignments

Medicare enrollment records show Joshua Edgerton reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Usa Health Physician Billing Services LLC

6.2 mi

Emergency Medicine

2451 UNIVERSITY HOSPITAL DR
Mobile, AL 36617

Reassigned Medicare billing, Alabama enrollment
857 clinicians in this Medicare group

NPI 1285292912 (251) 470-7300

Dlp Rutherford Physician Practices LLC

482 mi

Orthopaedic Surgery

139 DOCTOR HENRY NORRIS DR
Rutherfordton, NC 28139

Reassigned Medicare billing, North Carolina enrollment
76 clinicians in this Medicare group

NPI 1275943698 (828) 287-9260

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 9

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 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.

60 services50 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.

48 services37 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

41 services38 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.

35 services35 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

31 services30 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.

27 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36608 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

$81.90 typical visit price

range $52.65 – $161.63

Typical copayment $20.47 (range $13.16 – $40.40)

Most-billed visit code 99203

Established Patient

$66.08 typical visit price

range $16.56 – $131.65

Typical copayment $16.52 (range $4.14 – $32.91)

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.

Reported Quality Measures

Breast Cancer Screening

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer

14%145 patients1/55-star benchmark: 92%

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

2%206 patients1/55-star benchmark: 100%

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

45%286 patients3/55-star benchmark: 85%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

98%1,224 patients4/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

99%584 patients5/55-star benchmark: 99%

Falls: Screening for Future Fall Risk

Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period

1%168 patients1/55-star benchmark: 99%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

98%361 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

51%676 patients3/55-star benchmark: 97%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

7%168 patients1/55-star benchmark: 90%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

21%540 patients1/55-star benchmark: 97%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen

1%506 patients1/55-star benchmark: 96%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 83% · 301 patients

Patients tobacco: 4% · 26 patients

59%194 patients3/55-star benchmark: 98%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

98%676 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

3%676 patients1/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

15%676 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

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

Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories A6550

DME-Other DME · category DE000N

1 supplier14 claims140 services$22.86 avg. paid by Medicare

Canister, disposable, used with suction pump, each A7000

DME-Other DME · category DE000N

1 supplier14 claims100 services$6.94 avg. paid by Medicare

Negative pressure wound therapy electrical pump, stationary or portable E2402

DME-Other DME · category DE000N

1 supplier13 claims13 services$969.18 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 5

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

DR. JAY H. MURRAY M.D.

Surgery