ADVANCED FAMILY MEDICAL CLINIC MOUNT VERNON
NPI 1578090403
Clinic/Center - Rural Health in Somerset, KY
About Advanced Family Medical Clinic Mount Vernon NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ADVANCED FAMILY MEDICAL CLINIC MOUNT VERNON (NPI 1578090403), doing business as Advanced Family Medical Clinic, is a healthcare organization registered as a rural health in Somerset, Kentucky and active in the NPI registry since May 2017. The organization holds a CLIA Waiver certificate valid through June 11, 2027 and lists Khursheed Akram Siddiqui, Medical Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Advanced Family Medical Clinic Mount Vernon is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
16Medicare enrollment records show 16 clinicians reassign Medicare billing to Advanced Family Medical Clinic Mount Vernon, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 5
Clinicians, nearest first (16)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 18D2132041
Advanced Family Medical Clinic Mt Vernon Dba Advanced Family Medical Clinic · Somerset, KYFrequently 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 Advanced Family Medical Clinic Mount Vernon's NPI number?
The NPI number for Advanced Family Medical Clinic Mount Vernon is 1578090403. It was assigned to this organization in the NPPES registry on May 23, 2017. The provider is doing business as Advanced Family Medical Clinic.
Where is Advanced Family Medical Clinic Mount Vernon located?
Advanced Family Medical Clinic Mount Vernon is located at 79 Sarahs Ln, Somerset, KY 42503. The listed phone number is (606) 687-9017.
What is Advanced Family Medical Clinic Mount Vernon's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.
Is Advanced Family Medical Clinic Mount Vernon enrolled in Medicare?
Yes. Advanced Family Medical Clinic Mount Vernon is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Advanced Family Medical Clinic Mount Vernon?
According to the CMS Revalidation Reassignment List (October 2026 release), 16 clinicians in 5 Medicare specialties reassign their Medicare billing to Advanced Family Medical Clinic Mount Vernon. A 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 the clinician's services. The largest specialties are Nurse Practitioner (10), Family Practice (3) and Anesthesiology (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Advanced Family Medical Clinic Mount Vernon hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 18D2132041) is associated with this NPI, valid through June 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Advanced Family Medical Clinic Mount Vernon accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield list Advanced Family Medical Clinic Mount Vernon 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 Advanced Family Medical Clinic Mount Vernon was last updated on January 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.
# Advanced Family Medical Clinic Mount Vernon · NPI 1578090403
Rural Health organization in Somerset, Kentucky. Organization record, active in the CMS NPPES registry since May 23, 2017.
## Identity
- **NPI:** 1578090403 (Entity type: Organization)
- **Enumerated:** May 23, 2017
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Also known as:** Advanced Family Medical Clinic (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Khursheed Siddiqui, MEDICAL DIRECTOR
## Practice location
- **Address:** 79 SARAHS LN, Somerset, KY 42503-2789
- **Phone:** (606) 687-9017 · **Fax:** (606) 655-1030
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 16 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (10), Family Practice (3), Anesthesiology (1); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 16, 2026
- **Other identifiers:** Medicaid 7100503150 (KY)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1578090403) · Data from the CMS NPPES public registry.