DR. THOMAS W STONE M.D.
NPI 1528064219
Ophthalmology - Retina Specialist in Louisville, KY

Active since June 27, 2005PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
6450 DUTCHMANS PKWY, LOUISVILLE, KY 40205(859) 263-3900 Get Directions Write a Review

NPPES record last updated: July 12, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 12, 2023, May 8, 2017, Jul 14, 2016 (3 updates tracked since 2016).

About Dr. Thomas W Stone M.d. NPPES

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

DR. THOMAS W STONE M.D. (NPI 1528064219) is an individual retina specialist in Louisville, Kentucky, licensed in Kentucky (37096) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, maintains a secondary practice location in Lexington, and is a graduate of Other (1995).

NPPES Registry Identity

NPI1528064219
Entity TypeIndividualMale
Primary Taxonomy207WX0107X
Provider Legal NameDR. THOMAS W STONECredential: M.D.
Location Address6450 DUTCHMANS PKWYLouisville, KY 40205-3338
Mailing Address120 N Eagle Creek Dr, Ste 500Lexington, KY 40509-1827 · (859) 263-3900 · Fax (859) 263-3757
Sole ProprietorNo
Medical School CMSOtherGraduated 1995
Enumeration DateJune 27, 2005
Last NPPES UpdateJuly 12, 20233 updates tracked since enumeration
NPPES CertifiedJuly 12, 2023
NPI 1528064219 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0107X
License Licensed in KY · 37096
Definition
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
Also ListedOphthalmologyTaxonomy 207W00000X · License 37096 (KY)
6450 DUTCHMANS PKWY, Louisville, KY 40205

Secondary Practice Location 1

Location 1120 N Eagle Creek Dr, Ste 500Lexington, KY 40509-1827 · Phone (859) 263-3900 · Fax (859) 263-3757

Other Identifiers 3

Medicaid1811027000WV
Medicaid64045701KY
Medicaid2318370OH

Accepted Insurance

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

Dr. Thomas W Stone 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 ID1052591567
PECOS Enrollment IDI20110215000636, I20200421000379
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 18

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.

Injection, faricimab-svoa, 0.1 mg J2777
Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.
19,680 services59 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
2,333 services770 patients
Injection, aflibercept, 1 mg J0178
Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.
1,600 services175 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
1,422 services307 patients
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.
658 services333 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.
630 services433 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40205 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
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40

Reported Quality Measures

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%509 patients5/55-star benchmark: 100%
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus…
89%423 patients4/55-star benchmark: 100%
Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during…
95%431 patients4/55-star benchmark: 100%
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.
92%5,745 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.
95%757 patients4/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
95%42 patients4/55-star benchmark: 98%
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.
92%812 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.
85%2,472 patients4/55-star benchmark: 100%
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months
99%134 patients4/55-star benchmark: 100%
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…
91%2,472 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…
81%2,472 patients5/55-star benchmark: 79%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 1,191 patients
0%1,191 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.

Other Providers at the Same Location NPPES

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

Psychologist
6450 DUTCHMANS PKWY
LOUISVILLE, KY 40205

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 Thomas Stone's NPI number?

The NPI number for Thomas Stone is 1528064219. It was assigned to this individual provider in the NPPES registry on June 27, 2005.

Where is Thomas Stone located?

Thomas Stone practices at 6450 Dutchmans Pkwy, Louisville, KY 40205. The listed phone number is (859) 263-3900.

What is Thomas Stone's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Is Thomas Stone enrolled in Medicare?

Yes. Thomas Stone 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.

What insurance does Thomas Stone accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and Molina Healthcare list Thomas Stone 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.

When was this NPI record last updated?

The NPPES record for Thomas Stone was last updated on July 12, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.