SONY THEKKETHALA SEBASTIAN D.O.
NPI 1396165866
Hospitalist in Ashland, KY

Q: What is Sony Sebastian's NPI number?

The NPI number for Sony Sebastian is 1396165866. It was assigned to this individual provider in the NPPES registry on April 23, 2014.

Q: What is Sony Sebastian's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Q: When was this NPI record last updated?

The NPPES record for Sony Sebastian was last updated on December 14, 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.

Active since April 23, 2014PECOS EnrolledAccepts Medicare Assignment

82.94/100

CMS Quality Rating

2201 LEXINGTON AVE, ASHLAND, KY 41101(606) 408-4000(606) 408-6825 Get Directions Write a Review

NPPES record last updated: December 14, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 14, 2020, Aug 15, 2017 (2 updates tracked since 2017).

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About Sony Thekkethala Sebastian D.o. NPPES

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

SONY THEKKETHALA SEBASTIAN D.O. (NPI 1396165866) is an individual hospitalist provider in Ashland, Kentucky, licensed in Kentucky (04143) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS, is affiliated with King's Daughters' Medical Center, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1396165866

Entity TypeIndividualMale

Primary Taxonomy208M00000X

Provider Legal NameSONY THEKKETHALA SEBASTIANCredential: D.O.

Location Address2201 LEXINGTON AVEAshland, KY 41101-2843

Mailing AddressPo Box 2379Ashland, KY 41105-2379 · (606) 408-6200 · Fax (606) 408-6612

Phone(606) 408-4000

Fax(606) 408-6825

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateApril 23, 2014

Last NPPES UpdateDecember 14, 20202 updates tracked since enumeration

NPPES CertifiedDecember 14, 2020

✔ NPI 1396165866 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

License✔ Licensed in KY · 04143

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedEmergency MedicineTaxonomy 207P00000X · License 04143 (KY)

Also ListedFamily MedicineTaxonomy 207Q00000X · License 04143 (KY)

2201 LEXINGTON AVE, Ashland, KY 41101

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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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Sony Thekkethala Sebastian D.o. 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 ID749402758

PECOS Enrollment IDI20170829004464

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 Sony Sebastian reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Kings Daughters Medical Specialties Inc

Same address

Family Medicine

2201 LEXINGTON AVE
Ashland, KY 41101

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

NPI 1669791323 (606) 408-4000

Southeastern Emergency Physicians LLC

65 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

Cogent Healthcare Of Kentucky, Psc

107 mi

Internal Medicine

1 SAINT JOSEPH DR
Lexington, KY 40504

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

NPI 1053362293 (859) 313-1000

Hospital Medicine Services Of Tennessee PC

129 mi

Hospitalist

600 WILSON CREEK RD
Lawrenceburg, IN 47025

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

NPI 1528433802 (812) 537-1010

24 On Physicians, PC

130 mi

Hospitalist

217 S 3RD ST
Danville, KY 40422

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

NPI 1679522346 (800) 923-2247

Southeastern Physician Services PC

191 mi

Hospitalist

990 OAK RIDGE TPKE
Oak Ridge, TN 37830

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

NPI 1083835441 (865) 481-1000

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 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.

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.

693 services238 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.

210 services205 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

195 services184 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

151 services143 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

149 services69 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

19 services19 patients

Hospital Affiliations CMS Care Compare 5

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

King's Daughters' Medical Center

Acute Care Hospitals · Ashland, KY

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180009

Location2201 Lexington AvenueAshland, KY 41101 · Boyd County

Emergency services

Three Rivers Medical Center

Acute Care Hospitals · Louisa, KY

3/5 CMS rating

OwnershipProprietary

CMS Certification Number180128

Location2485 Highway 644Louisa, KY 41230 · Lawrence County

Emergency services

Southern Ohio Medical Center

Acute Care Hospitals · Portsmouth, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number360008

Location1805 27th StreetPortsmouth, OH 45662 · Scioto County

Emergency services Birthing friendly

Kings Daughters Medical Center Ohio

Acute Care Hospitals · Portsmouth, OH

OwnershipVoluntary non-profit - Private

CMS Certification Number360361

Location1901 Argonne RoadPortsmouth, OH 45662 · Scioto County

Emergency services

St Mary's Medical Center

Acute Care Hospitals · Huntington, WV

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number510007

Location2900 1st AvenueHuntington, WV 25702 · Cabell County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41101 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.

82.94/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

70.01

Promoting Interoperability

100

Improvement Activities

Cost

65.57

Reported Quality Measures

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…

100%75 patients5/55-star benchmark: 100%

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 2

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

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

DME-Oxygen and Supplies · category DC000N

1 supplier36 claims36 services$21.26 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

1 supplier36 claims36 services$118.00 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 20

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

DALKEITH FITZLAWSON TUCKER D.O.

Emergency Medicine

2201 LEXINGTON AVE
ASHLAND, KY 41101

Boyd County (606) 408-0605

ELIZABETH JEAN LOAN APRN

Nurse Practitioner (Family)

2201 LEXINGTON AVE
ASHLAND, KY 41101

Boyd County (606) 408-4000

DONALD A KRAFT MD

Emergency Medicine

2201 LEXINGTON AVE
ASHLAND, KY 41101

Boyd County (606) 327-4000

DOUGLAS M MOTTLEY M.D.

Specialist

2201 LEXINGTON AVE, SUITE 8B
ASHLAND, KY 41101

Boyd County (606) 327-5190

JASON G. ELLIS CRNA

Nurse Anesthetist, Certified Registered

2201 LEXINGTON AVE
ASHLAND, KY 41101

Boyd County (606) 408-4000

ASHLEY LUSTER

Pharmacist

2201 LEXINGTON AVE
ASHLAND, KY 41101

Boyd County (606) 408-1225

HASSAN R ABUL-KHOUDOUD MD

Hospitalist

2201 LEXINGTON AVE
ASHLAND, KY 41101

Boyd County (606) 408-4000

ASHLAND HOSPITAL CORPORATION

Durable Medical Equipment & Medical Supplies

2201 LEXINGTON AVE
ASHLAND, KY 41101

Boyd County (606) 408-4000

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 Sony Sebastian's NPI number?

The NPI number for Sony Sebastian is 1396165866. It was assigned to this individual provider in the NPPES registry on April 23, 2014.

Where is Sony Sebastian located?

Sony Sebastian practices at 2201 Lexington Ave, Ashland, KY 41101. The listed phone number is (606) 408-4000.

What is Sony Sebastian's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Sony Sebastian enrolled in Medicare?

Yes. Sony Sebastian 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.

Which organizations bill Medicare for Sony Sebastian's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sony Sebastian reassigns Medicare benefits to 6 organizations: Kings Daughters Medical Specialties Inc (Ashland, KY), Southeastern Emergency Physicians LLC (Maysville, KY), Cogent Healthcare Of Kentucky, Psc (Lexington, KY), Hospital Medicine Services Of Tennessee PC (Lawrenceburg, IN), 24 On Physicians, PC (Danville, KY) and 1 more organization, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sony Sebastian's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sony Sebastian accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and CareSource list Sony Sebastian 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 Sony Sebastian affiliated with any hospitals?

According to CMS data, Sony Sebastian is affiliated with King's Daughters' Medical Center, Three Rivers Medical Center, Southern Ohio Medical Center, Kings Daughters Medical Center Ohio and St Mary's Medical Center.

When was this NPI record last updated?

The NPPES record for Sony Sebastian was last updated on December 14, 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.