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EDWARD J. TANOUS JR. MD
NPI 1528060043
Pathology - Anatomic Pathology & Clinical Pathology in Winchester, KY

Active since August 15, 2005PECOS EnrolledAccepts Medicare Assignment
81.77/100
CMS Quality Rating
175 HOSPITAL DRIVE, WINCHESTER, KY 40391(859) 745-3500(859) 737-8350 Get Directions Write a Review

NPPES record last updated: September 25, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Edward J. Tanous Jr. Md NPPES

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

EDWARD J. TANOUS JR. MD (NPI 1528060043) is an individual anatomic pathology & clinical pathology provider in Winchester, Kentucky, licensed in Kentucky (25971) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Saint Joseph Hospital, and is a graduate of University Of Mississippi School Of Medicine (1987).

NPPES Registry Identity

NPI1528060043
Entity TypeIndividualMale
Primary Taxonomy207ZP0102X
Provider Legal NameEDWARD J. TANOUS JR.Credential: MD
Location Address175 HOSPITAL DRIVEWinchester, KY 40391-1169
Mailing Address3529 Solutions CenterChicago, IL 60677-3005 · (800) 288-8325 · Fax (419) 866-5453
Phone(859) 745-3500
Fax(859) 737-8350
Sole ProprietorNo
Medical School CMSUniversity Of Mississippi School Of MedicineGraduated 1987
Enumeration DateAugust 15, 2005
Last NPPES UpdateSeptember 25, 2012
✔ NPI 1528060043 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
License✔ Licensed in KY · 25971
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
175 HOSPITAL DRIVE, Winchester, KY 40391
Open in Google Maps ↗

Other Identifiers 5

Medicare UPINF27727KY
Medicare PIN0258702KY
Medicaid64259716KY
Medicare PIN2587KY
Medicare PIN2280KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee.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

Edward J. Tanous 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 ID1254492150
PECOS Enrollment IDI20100209000418
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

2

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

Kentucky Medical Services Foundation, Inc
14 mi
Internal Medicine
2333 ALUMNI PARK PLZ, SUITE 200
Lexington, KY 40517
  • Reassigned Medicare billing, Kentucky enrollment
  • 1,502 clinicians in this Medicare group
NPI 1326091448 (859) 257-7910
Chipps, Caffrey & Dubilier, P.S.C
17 mi
Anatomic Pathology & Clinical Pathology
290 BIG RUN RD
Lexington, KY 40503
  • Reassigned Medicare billing, Kentucky enrollment
  • 21 clinicians in this Medicare group
NPI 1336148683 (859) 278-9513

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 10

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.

Pathology examination of tissue using a microscope, intermediate complexity 88305
A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.
1,150 services471 patients
Special stained specimen slides to examine tissue, each additional procedure 88341
Special stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.
127 services30 patients
Pathology examination of tissue using a microscope, moderately low complexity 88304
A pathology examination of tissue, moderately low complexity, involves studying a small sample of your body tissue under a microscope. It helps to identify any abnormal cells or diseases. It's a routine procedure, not complex, and provides crucial insights for your diagnosis.
72 services65 patients
Special stained specimen slides to examine tissue, initial procedure 88342
This procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.
65 services62 patients
Pathology examination of tissue using a microscope, moderately high complexity 88307
A pathology examination of tissue with moderate complexity involves a detailed study of a small tissue sample from your body. Using a microscope, experts analyze the tissue's structure and cells to identify any abnormalities. This helps in diagnosing various health conditions accurately.
61 services39 patients
Preparation of tissue for examination by removing any calcium present 88311
This procedure involves treating tissue samples to remove any calcium, which can interfere with the examination. The tissue is soaked in a special solution that safely dissolves the calcium, leaving the tissue intact for accurate analysis. This helps in making precise diagnoses.
45 services33 patients

Hospital Affiliations CMS Care Compare 5

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

Saint Joseph Hospital

Acute Care Hospitals · Lexington, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number180010
LocationOne Saint Joseph DriveLexington, KY 40504 · Fayette County
Emergency services

Taylor Regional Hospital

Acute Care Hospitals · Campbellsville, KY
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number180087
Location1700 Old Lebanon RoadCampbellsville, KY 42718 · Taylor County
Emergency services

Baptist Health Deaconess Madisonville

Acute Care Hospitals · Madisonville, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180093
Location900 Hospital DriveMadisonville, KY 42431 · Hopkins County
Emergency services Birthing friendly

Lake Cumberland Regional Hospital

Acute Care Hospitals · Somerset, KY
2/5 CMS rating
OwnershipProprietary
CMS Certification Number180132
Location305 Langdon StreetSomerset, KY 42503 · Pulaski County
Emergency services Birthing friendly

Saint Joseph East

Acute Care Hospitals · Lexington, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180143
Location150 North Eagle Creek DriveLexington, KY 40509 · Fayette County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40391 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.

81.77/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality75.63
Improvement Activities40

Other Providers at the Same Location NPPES

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

BLUEGRASS PATHOLOGY ASSOCIATES PSC
Pathology (Anatomic Pathology & Clinical Pathology)
175 HOSPITAL DRIVE
WINCHESTER, KY 40391
Clark County (859) 745-3500

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 Edward Tanous's NPI number?

The NPI number for Edward Tanous is 1528060043. It was assigned to this individual provider in the NPPES registry on August 15, 2005.

Where is Edward Tanous located?

Edward Tanous practices at 175 Hospital Drive, Winchester, KY 40391. The listed phone number is (859) 745-3500.

What is Edward Tanous's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is Edward Tanous enrolled in Medicare?

Yes. Edward Tanous 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 Edward Tanous's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Edward Tanous reassigns Medicare benefits to 2 organizations: Kentucky Medical Services Foundation, Inc (Lexington, KY) and Chipps, Caffrey & Dubilier, P.S.C (Lexington, KY). 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 Edward Tanous's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Edward Tanous accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter of Tennessee list Edward Tanous 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 Edward Tanous affiliated with any hospitals?

According to CMS data, Edward Tanous is affiliated with Saint Joseph Hospital, Taylor Regional Hospital, Baptist Health Deaconess Madisonville, Lake Cumberland Regional Hospital and Saint Joseph East.

When was this NPI record last updated?

The NPPES record for Edward Tanous was last updated on September 25, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.