SEAN M DENTON MD
NPI 1376564963
Emergency Medicine in Madisonville, KY

Active since July 21, 2006PECOS EnrolledAccepts Medicare Assignment
95.5/100
CMS Quality Rating
900 HOSPITAL DR, MADISONVILLE, KY 42431(270) 326-4520(270) 875-5538 Get Directions Write a Review

NPPES record last updated: December 22, 2009. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Sean M Denton Md NPPES

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

SEAN M DENTON MD (NPI 1376564963) is an individual emergency medicine provider in Madisonville, Kentucky, licensed in Kentucky (40983) and active in the NPI registry since July 2006. He 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 (2004).

NPPES Registry Identity

NPI1376564963
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameSEAN M DENTONCredential: MD
Location Address900 HOSPITAL DRMadisonville, KY 42431-1644
Mailing AddressPo Box 1558Shelbyville, KY 40066-1558 · (502) 386-4702
Fax(270) 875-5538
Sole ProprietorNo
Medical School CMSUniversity Of Louisville School Of MedicineGraduated 2004
Enumeration DateJuly 21, 2006
Last NPPES UpdateDecember 22, 2009
NPI 1376564963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License Licensed in KY · 40983
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
900 HOSPITAL DR, Madisonville, KY 42431

Other Identifiers 6

Medicaid7100003360KY
Medicare PIN00280107KY
Medicare PIN0623641
Other40983KY · License
Other50012266KY · Passport Health Plan
Medicare PINP00761111

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

Sean M Denton 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 ID3072511807
PECOS Enrollment IDI20061110000059
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.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
176 services172 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
94 services91 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.
77 services75 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
59 services59 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.
17 services17 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

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 42431 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
$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.

95.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality89.59
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

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

Pharmacist
900 HOSPITAL DR
MADISONVILLE, KY 42431
Nurse Anesthetist, Certified Registered
900 HOSPITAL DR
MADISONVILLE, KY 42431
Nurse Anesthetist, Certified Registered
900 HOSPITAL DR
MADISONVILLE, KY 42431
Specialist/Technologist, Other (Surgical Assistant)
900 HOSPITAL DR
MADISONVILLE, KY 42431
Specialist/Technologist, Other (Surgical Assistant)
900 HOSPITAL DR
MADISONVILLE, KY 42431
Nurse Practitioner (Acute Care)
900 HOSPITAL DR
MADISONVILLE, KY 42431
Internal Medicine (Hematology & Oncology)
900 HOSPITAL DR
MADISONVILLE, KY 42431
Nurse Anesthetist, Certified Registered
900 HOSPITAL DR
MADISONVILLE, KY 42431

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 Sean Denton's NPI number?

The NPI number for Sean Denton is 1376564963. It was assigned to this individual provider in the NPPES registry on July 21, 2006.

Where is Sean Denton located?

Sean Denton practices at 900 Hospital Dr, Madisonville, KY 42431. The listed phone number is (270) 326-4520.

What is Sean Denton's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Sean Denton enrolled in Medicare?

Yes. Sean Denton 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.

Is Sean Denton affiliated with any hospitals?

According to CMS data, Sean Denton is affiliated with Jewish Hospital & St Mary's Healthcare and Baptist Health Louisville.

When was this NPI record last updated?

The NPPES record for Sean Denton was last updated on December 22, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.