JUSTIN B SEDLAK MD
NPI 1558468215
Pathology - Anatomic Pathology & Clinical Pathology in Lexington, KY

Q: What is Justin Sedlak's NPI number?

The NPI number for Justin Sedlak is 1558468215. It was assigned to this individual provider in the NPPES registry on September 17, 2006.

Q: What is Justin Sedlak's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Justin Sedlak was last updated on March 5, 2021. 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 September 17, 2006PECOS Enrolled

81.77/100

CMS Quality Rating

290 BIG RUN RD, LEXINGTON, KY 40503(859) 278-9513 Get Directions Write a Review

NPPES record last updated: March 5, 2021. Verified against the NPPES registry weekly; last sync: October 04, 2026.

On this page

About Justin B Sedlak Md NPPES

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

JUSTIN B SEDLAK MD (NPI 1558468215) is an individual anatomic pathology & clinical pathology provider in Lexington, Kentucky, licensed in Kentucky (30321) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1558468215

Entity TypeIndividualMale

Primary Taxonomy207ZP0102X

Provider Legal NameJUSTIN B SEDLAKCredential: MD

Location Address290 BIG RUN RDLexington, KY 40503-2903

Mailing Address290 Big Run RdLexington, KY 40503-2903 · (859) 278-9513

Phone(859) 278-9513

Sole ProprietorNo

Enumeration DateSeptember 17, 2006

Last NPPES UpdateMarch 5, 2021

NPPES CertifiedMarch 5, 2021

✔ NPI 1558468215 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 · 30321

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.

290 BIG RUN RD, Lexington, KY 40503

Open in Google Maps ↗

Other Identifiers 4

Other30321KY · License

Medicaid64303217KY

Other000000044324Bcbs Provider Number

Other000000804466KY · Bcbs- Mmc/powderly Clinic

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Justin B Sedlak Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40503 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

Quality

75.63

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.

ALEXANDER PATRICK SMITH

Pathology (Anatomic Pathology & Clinical Pathology)