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

Q: 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.

Q: What is Sean Denton's specialty?

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

Q: 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.

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: October 25, 2026.

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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

Phone(270) 326-4520

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

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Other Identifiers 6

Medicaid7100003360KY

Medicare PIN00280107KY

Medicare PIN0623641

Other40983KY · License

Other50012266KY · Passport Health Plan

Medicare PINP00761111

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

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.

Medicare Billing Reassignments

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

Baptist Health Medical Group Inc

Same address

Rural Health

800 HOSPITAL DR FL 2
Madisonville, KY 42431

Reassigned Medicare billing, Kentucky enrollment
1,441 clinicians in this Medicare group

NPI 1265072946 (270) 326-3900

Southeastern Emergency Physicians LLC

220 mi

Emergency Medicine

989 MEDICAL PARK DR
Maysville, KY 41056

Reassigned Medicare billing, Kentucky enrollment
828 clinicians in this Medicare group

NPI 1356379382 (606) 759-5311

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 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

Quality

89.59

Promoting Interoperability

100

Improvement Activities

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.

CADE CUNNINGHAM

Pharmacist