DR. SCOTT D PETHKE M.D.
NPI 1609828094
Internal Medicine - Pulmonary Disease in Augusta, GA

Q: What is Scott Pethke's NPI number?

The NPI number for Scott Pethke is 1609828094. It was assigned to this individual provider in the NPPES registry on May 16, 2006.

Q: What is Scott Pethke's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Scott Pethke was last updated on July 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since May 16, 2006PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

1301 BROAD ST, AUGUSTA, GA 30901(706) 922-5864(706) 922-5819 Get Directions Write a Review

NPPES record last updated: July 31, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

On this page

About Dr. Scott D Pethke M.d. NPPES

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

DR. SCOTT D PETHKE M.D. (NPI 1609828094) is an individual pulmonary disease provider in Augusta, Georgia, licensed in Georgia (066307) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Piedmont Augusta Hospital, and is a graduate of Louisiana State University School Of Medicine In New Orleans (1993).

NPPES Registry Identity

NPI1609828094

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameDR. SCOTT D PETHKECredential: M.D.

Location Address1301 BROAD STAugusta, GA 30901-1055

Mailing Address1301 Broad StAugusta, GA 30901-1055

Phone(706) 922-5864

Fax(706) 922-5819

Sole ProprietorNo

Medical School CMSLouisiana State University School Of Medicine In New OrleansGraduated 1993

Enumeration DateMay 16, 2006

Last NPPES UpdateJuly 31, 2025

NPPES CertifiedJuly 31, 2025

✔ NPI 1609828094 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

Licenses✔ Licensed in GA · 066307✔ Licensed in LA · 10684R

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 66307 (GA)

1301 BROAD ST, Augusta, GA 30901

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Other Identifiers 3

Medicaid1492582LA

Other5808779LA · Aetna

Other4800148LA · United Healthcare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.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. Scott D Pethke 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 ID2860565116

PECOS Enrollment IDI20110707000191

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

Medicare enrollment records show Scott Pethke reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Augusta Lung Associates

Same address

Specialist

1301 BROAD ST
Augusta, GA 30901

Reassigned Medicare billing, Georgia enrollment
5 clinicians in this Medicare group

NPI 1619043049 (706) 922-5864

Piedmont Specialty Hospital Billing LLC

157 mi

Internal Medicine

1266 HIGHWAY 515 S
Jasper, GA 30143

Reassigned Medicare billing, Georgia enrollment
317 clinicians in this Medicare group

NPI 1699290510 (770) 801-2500

Piedmont Providers LLC

160 mi

Internal Medicine

220 J L WHITE DR STE 120
Jasper, GA 30143

Reassigned Medicare billing, Georgia enrollment
689 clinicians in this Medicare group

NPI 1548273592 (770) 801-2500

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 16

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

663 services185 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.

371 services229 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

231 services45 patients

Test to measure expiratory airflow and volume 94010

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

202 services187 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

199 services184 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

113 services108 patients

Ct scan of chest without contrast 71250

A CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.

70 services64 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

65 services65 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.

49 services46 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

40 services40 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.

24 services24 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

21 services21 patients

Test to examine how well the lungs exchange gases 94729

19 services19 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.

18 services18 patients

Test to measure expiratory airflow and volume 94010

16 services16 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

14 services14 patients

Hospital Affiliations CMS Care Compare 4

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

Piedmont Augusta Hospital

Acute Care Hospitals · Augusta, GA

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110028

Location1350 Walton WayAugusta, GA 30901 · Richmond County

Emergency services Birthing friendly

Au Medical Center

Acute Care Hospitals · Augusta, GA

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110034

Location1120 15th StreetAugusta, GA 30912 · Richmond County

Emergency services Birthing friendly

University Mcduffie County Regional Medical Center

Acute Care Hospitals · Thomson, GA

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110111

Location2460 Washington RoadThomson, GA 30824 · Mc Duffie County

Emergency services

Aiken Regional Medical Center

Acute Care Hospitals · Aiken, SC

2/5 CMS rating

OwnershipProprietary

CMS Certification Number420082

Location302 University ParkwayAiken, SC 29801 · Aiken County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30901 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

$124.10 typical visit price

range $53.31 – $164.04

Typical copayment $31.02 (range $13.32 – $41.01)

Most-billed visit code 99204

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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.

75/100

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

Scored as part of a group practice

Reported Quality Measures

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

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

99%372 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 26

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

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

8 suppliers68 claims68 services$33.52 avg. paid by Medicare

Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003

DME-Other DME · category DE000N

3 suppliers18 claims36 services$1.22 avg. paid by Medicare

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

DME-Other DME · category DE001N

9 suppliers52 claims52 services$79.30 avg. paid by Medicare

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

DME-Other DME · category DE001N

8 suppliers49 claims126 services$29.74 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

6 suppliers17 claims86 services$15.56 avg. paid by Medicare

Pillow for use on nasal cannula type interface, replacement only, pair A7033

DME-Other DME · category DE001N

6 suppliers27 claims156 services$12.29 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

10 suppliers55 claims55 services$45.05 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

12 suppliers60 claims60 services$15.44 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

5 suppliers24 claims24 services$10.25 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

10 suppliers93 claims500 services$1.70 avg. paid by Medicare

Filter, non disposable, used with positive airway pressure device A7039

DME-Other DME · category DE001N

8 suppliers19 claims19 services$5.22 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

11 suppliers40 claims40 services$11.43 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

8 suppliers103 claims107 services$15.57 avg. paid by Medicare

Portable oxygen contents, gaseous, 1 month's supply = 1 unit E0443

DME-Oxygen and Supplies · category DC000N

2 suppliers14 claims16 services$49.89 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

3 suppliers52 claims52 services$844.06 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

4 suppliers28 claims28 services$5.00 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

6 suppliers81 claims81 services$30.04 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

8 suppliers178 claims182 services$59.88 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

3 suppliers57 claims57 services$31.47 avg. paid by Medicare

Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605

DME-Drugs Administered Through DME · category DG006N

3 suppliers16 claims960 services$3.84 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

3 suppliers13 claims1,824 services$0.03 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

4 suppliers26 claims2,040 services$0.09 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

5 suppliers32 claims1,830 services$0.79 avg. paid by Medicare

Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram J7644

DME-Drugs Administered Through DME · category DG006N

2 suppliers11 claims305 services$0.15 avg. paid by Medicare

Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram J7677

DME-Drugs Administered Through DME · category DG006N

2 suppliers13 claims68,250 services$0.14 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

9 suppliers56 claims56 services$25.14 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 5

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

BRENT MICHAEL BERMINGHAM MD

Internal Medicine (Pulmonary Disease)

1301 BROAD ST
AUGUSTA, GA 30901

Richmond County (706) 922-5864

AUGUSTA LUNG ASSOCIATES

Specialist

1301 BROAD ST
AUGUSTA, GA 30901

Richmond County (706) 922-5864

MICHAEL STEWARD HAYNES M.D.

Internal Medicine (Pulmonary Disease)

1301 BROAD ST
AUGUSTA, GA 30901

Richmond County (706) 922-5864

FALCON MEDICAL GROUP

Specialist

1301 BROAD ST, SUITE 102
AUGUSTA, GA 30901

Richmond County (706) 723-5894

ALFRED LYNNE BRANNEN II MD

Internal Medicine (Pulmonary Disease)

1301 BROAD ST
AUGUSTA, GA 30901

Richmond County (706) 922-5864

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 Scott Pethke's NPI number?

The NPI number for Scott Pethke is 1609828094. It was assigned to this individual provider in the NPPES registry on May 16, 2006.

Where is Scott Pethke located?

Scott Pethke practices at 1301 Broad St, Augusta, GA 30901. The listed phone number is (706) 922-5864.

What is Scott Pethke's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Scott Pethke enrolled in Medicare?

Yes. Scott Pethke 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 Scott Pethke's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Scott Pethke reassigns Medicare benefits to 3 organizations: Augusta Lung Associates (Augusta, GA), Piedmont Specialty Hospital Billing LLC (Jasper, GA) and Piedmont Providers LLC (Jasper, GA). 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 Scott Pethke's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Scott Pethke accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Scott Pethke 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 Scott Pethke affiliated with any hospitals?

According to CMS data, Scott Pethke is affiliated with Piedmont Augusta Hospital, Au Medical Center, University Mcduffie County Regional Medical Center and Aiken Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Scott Pethke was last updated on July 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.