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DR. ANIL DUGGAL MD
NPI 1578879300
Surgery - Surgery of the Hand in Pikeville, KY

Active since August 31, 2010PECOS EnrolledAccepts Medicare Assignment
86.86/100
CMS Quality Rating
911 BYPASS RD BLDG A, PIKEVILLE, KY 41501(606) 430-2206(606) 218-7506 Get Directions Write a Review

NPPES record last updated: June 8, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 8, 2022, May 20, 2021, Mar 16, 2020 and 2 more (5 updates tracked since 2017).

About Dr. Anil Duggal Md NPPES

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

DR. ANIL DUGGAL MD (NPI 1578879300) is an individual surgery of the hand provider in Pikeville, Kentucky, licensed in Kentucky (43614) and active in the NPI registry since August 2010. He is enrolled in Medicare PECOS, is affiliated with Pikeville Medical Center, and maintains a secondary practice location in Lexington.

NPPES Registry Identity

NPI1578879300
Entity TypeIndividualMale
Primary Taxonomy2086S0105X
Provider Legal NameDR. ANIL DUGGALCredential: MD
Location Address911 BYPASS RD BLDG APikeville, KY 41501-1689
Mailing AddressPo Box 432Pikeville, KY 41502-0432 · (606) 430-2206 · Fax (606) 218-7506
Phone(606) 430-2206
Fax(606) 218-7506
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateAugust 31, 2010
Last NPPES UpdateJune 8, 20225 updates tracked since enumeration
NPPES CertifiedJune 8, 2022
✔ NPI 1578879300 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Surgery of the HandAllopathic & Osteopathic Physicians
Taxonomy Code2086S0105X
License✔ Licensed in KY · 43614
Definition
A surgeon with expertise in the investigation, preservation and restoration by medical, surgical and rehabilitative means, of all structures of the upper extremity directly affecting the form and function of the hand and wrist.
Also ListedPlastic SurgeryTaxonomy 208200000X · License 43614 (KY)
911 BYPASS RD BLDG A, Pikeville, KY 41501
Open in Google Maps ↗

Secondary Practice Location 1

Location 1740 S Limestone St E101Lexington, KY 40536-4412 · Phone (859) 323-8082 · Fax (859) 257-5901

Other Identifiers 1

Medicaid710040080KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource.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

Dr. Anil Duggal 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 ID3678857497
PECOS Enrollment IDI20170222002952
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 Anil Duggal reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pikeville Medical Center Inc.
1.4 mi
Clinic/Center
254 CASSIDY BLVD
Pikeville, KY 41501
  • Reassigned Medicare billing, Kentucky enrollment
  • 579 clinicians in this Medicare group
NPI 1710207865 (606) 437-0123
Kentucky Medical Services Foundation, Inc
112 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

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 2

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 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.
58 services39 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
26 services26 patients

Hospital Affiliations CMS Care Compare

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

Pikeville Medical Center

Acute Care Hospitals · Pikeville, KY
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180044
Location911 Bypass RoadPikeville, KY 41501 · Pike County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41501 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
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.

86.86/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality72.39
Promoting Interoperability100
Improvement Activities40
Cost70.65

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.

MRS. WHITNEY P. BURTON PA-C
Physician Assistant
911 BYPASS RD BLDG A
PIKEVILLE, KY 41501
Pike County (606) 430-2201
DR. SHRAVANTI PONGALI MUTHU MD, MPH
Hospitalist
911 BYPASS RD BLDG A
PIKEVILLE, KY 41501
Pike County (606) 430-3500
AMY O JOHNSON MD
Surgery
911 BYPASS RD BLDG A
PIKEVILLE, KY 41501
Pike County (606) 430-2205
MATTHEW SEXTON M.D.
Anesthesiology (Critical Care Medicine)
911 BYPASS RD BLDG A
PIKEVILLE, KY 41501
Pike County (606) 430-3500
CAITLIN VICTORIA BERNIECE COLLIER
Nurse Practitioner (Family)
911 BYPASS RD BLDG A
PIKEVILLE, KY 41501
Pike County (606) 430-2208
BRIANNA I COLEMAN
Nurse Practitioner (Family)
911 BYPASS RD BLDG A
PIKEVILLE, KY 41501
Pike County (606) 430-2201
EMUESIRI CATHERINE OVWIGHO MD
Hospitalist
911 BYPASS RD BLDG A
PIKEVILLE, KY 41501
Pike County (606) 430-3500
TRULENA BENNER CRNA
Nurse Anesthetist, Certified Registered
911 BYPASS RD BLDG A
PIKEVILLE, KY 41501
Pike County (606) 430-3500

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 Anil Duggal's NPI number?

The NPI number for Anil Duggal is 1578879300. It was assigned to this individual provider in the NPPES registry on August 31, 2010.

Where is Anil Duggal located?

Anil Duggal practices at 911 Bypass Rd Bldg A, Pikeville, KY 41501. The listed phone number is (606) 430-2206.

What is Anil Duggal's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Surgery of the Hand, with taxonomy code 2086S0105X.

Is Anil Duggal enrolled in Medicare?

Yes. Anil Duggal 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 Anil Duggal's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Anil Duggal reassigns Medicare benefits to 2 organizations: Pikeville Medical Center Inc. (Pikeville, KY) and Kentucky Medical Services Foundation, Inc (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 Anil Duggal's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Anil Duggal accept?

Health plans from Anthem Blue Cross and Blue Shield and CareSource list Anil Duggal 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 Anil Duggal affiliated with any hospitals?

According to CMS data, Anil Duggal is affiliated with Pikeville Medical Center.

When was this NPI record last updated?

The NPPES record for Anil Duggal was last updated on June 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.