DR. SUZANNE MARIE PICA MD
NPI 1538233184
Internal Medicine in Winchester, KY

Q: What is Suzanne Pica's NPI number?

The NPI number for Suzanne Pica is 1538233184. It was assigned to this individual provider in the NPPES registry on November 17, 2006.

Q: What is Suzanne Pica's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Suzanne Pica was last updated on May 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 November 17, 2006PECOS EnrolledAccepts Medicare Assignment

96.68/100

CMS Quality Rating

505 SHOPPERS DR, SUITE 2, WINCHESTER, KY 40391(859) 744-1358(859) 744-3144 Get Directions Write a Review

NPPES record last updated: May 11, 2020. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Dr. Suzanne Marie Pica Md NPPES

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

DR. SUZANNE MARIE PICA MD (NPI 1538233184) is an individual internal medicine provider in Winchester, Kentucky, licensed in Kentucky (28114) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS, is affiliated with Clark Regional Medical Center, and is a graduate of University Of Florida College Of Medicine (1990).

NPPES Registry Identity

NPI1538233184

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameDR. SUZANNE MARIE PICACredential: MD

Location Address505 SHOPPERS DR, SUITE 2Winchester, KY 40391

Mailing Address505 Shoppers Dr, Suite 2Winchester, KY 40391 · (859) 744-1358 · Fax (859) 744-3144

Phone(859) 744-1358

Fax(859) 744-3144

Sole ProprietorYes

Medical School CMSUniversity Of Florida College Of MedicineGraduated 1990

Enumeration DateNovember 17, 2006

Last NPPES UpdateMay 11, 2020

NPPES CertifiedMay 11, 2020

✔ NPI 1538233184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in KY · 28114

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedPediatricsTaxonomy 208000000X · License 28114 (KY)

505 SHOPPERS DR, Winchester, KY 40391

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Other Identifiers 2

Other000000050542KY · Anthem Blue Cross

Medicaid64281140KY

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. Suzanne Marie Pica 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 ID648226373

PECOS Enrollment IDI20050325000438

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 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.

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.

135 services77 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.

122 services72 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

93 services93 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

43 services43 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.

33 services26 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

25 services21 patients

Hospital Affiliations CMS Care Compare 3

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

Clark Regional Medical Center

Acute Care Hospitals · Winchester, KY

3/5 CMS rating

OwnershipProprietary

CMS Certification Number180092

Location175 Hospital DriveWinchester, KY 40391 · Clark County

Emergency services Birthing friendly

Baptist Health Lexington

Acute Care Hospitals · Lexington, KY

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number180103

Location1740 Nicholasville RoadLexington, KY 40503 · Fayette 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.

96.68/100

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

Scored through an Alternative Payment Model

Quality

83.69

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Advance Care Plan

71%314 patients3/55-star benchmark: 100%

Colorectal Cancer Screening

81%437 patients4/55-star benchmark: 88%

Controlling High Blood Pressure

87%63 patients4/55-star benchmark: 91%

Diabetes: Eye Exam

60%105 patients3/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

19%105 patients4/55-star benchmark: 91%

e-Prescribing

99%1,006 patients4/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

34%668 patients2/55-star benchmark: 98%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

26%1,482 patients2/55-star benchmark: 61%

Provide Patients Electronic Access to Their Health Information

86%434 patients4/55-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 11

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

7 suppliers18 claims69 services$6.30 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

6 suppliers15 claims29 services$0.99 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

3 suppliers15 claims15 services$99.76 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

3 suppliers15 claims43 services$38.40 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

3 suppliers12 claims69 services$2.41 avg. paid by Medicare

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

DME-Oxygen and Supplies · category DC000N

2 suppliers23 claims23 services$15.31 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 10

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

ANITA GAYLE ROGERS M.D.

Emergency Medicine

505 SHOPPERS DR, SUITE 3
WINCHESTER, KY 40391

Clark County (859) 737-3911

DR. BRITTANY HALE

Physical Therapist