MR. ROBERT LEE THOMAS IV MD
NPI 1619978327
Surgery in Middlesboro, KY

Active since August 03, 2005PECOS EnrolledAccepts Medicare Assignment
97.4/100
CMS Quality Rating
123 N 19TH ST, SUITE B301, MIDDLESBORO, KY 40965(606) 248-7509 Get Directions Write a Review

NPPES record last updated: April 17, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Robert Lee Thomas Iv Md NPPES

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

MR. ROBERT LEE THOMAS IV MD (NPI 1619978327) is an individual surgery provider in Middlesboro, Kentucky, licensed in Tennessee (12835) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Middlesboro Arh Hospital, and is a graduate of University Of Tennessee, Hsc, College Of Medicine (1980).

NPPES Registry Identity

NPI1619978327
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameMR. ROBERT LEE THOMAS IVCredential: MD
Location Address123 N 19TH ST, SUITE B301Middlesboro, KY 40965-2865
Mailing AddressPo Box 340Middlesboro, KY 40965-0340 · (606) 278-7509
Sole ProprietorNo
Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 1980
Enumeration DateAugust 3, 2005
Last NPPES UpdateApril 17, 2013
NPI 1619978327 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License Licensed in TN · 12835
Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

123 N 19TH ST, Middlesboro, KY 40965

Other Identifiers 7

Medicare UPINA99239
Medicaid3028439TN
Medicare PIN0207501KY
Medicare PIN3028439TN
Medicaid64254337KY
Medicare PIN020025859KY
Medicare PIN020031760TN

Accepted Insurance

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

Mr. Robert Lee Thomas Iv 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 ID6800868696
PECOS Enrollment IDI20101215000276, I20120120000347
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 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.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
19 services19 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
11 services11 patients

Hospital Affiliations CMS Care Compare

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

Middlesboro Arh Hospital

Acute Care Hospitals · Middlesboro, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180020
Location3600 West Cumberland AvenueMiddlesboro, KY 40965 · Bell County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40965 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.

97.4/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality76.55
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 9

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

Internal Medicine
123 N 19TH ST, SUITE 201
MIDDLESBORO, KY 40965
Nurse Practitioner (Adult Health)
123 N 19TH ST
MIDDLESBORO, KY 40965
Surgery
123 N 19TH ST
MIDDLESBORO, KY 40965
Podiatrist (Foot & Ankle Surgery)
123 N 19TH ST
MIDDLESBORO, KY 40965
Dentist (Oral and Maxillofacial Surgery)
123 N 19TH ST
MIDDLESBORO, KY 40965
Nurse Practitioner (Family)
123 N 19TH ST, SUITE A201
MIDDLESBORO, KY 40965
Clinic/Center
123 N 19TH ST, SUITE 201
MIDDLESBORO, KY 40965
Nurse Practitioner (Family)
123 N 19TH ST
MIDDLESBORO, KY 40965

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 Robert Thomas's NPI number?

The NPI number for Robert Thomas is 1619978327. It was assigned to this individual provider in the NPPES registry on August 3, 2005.

Where is Robert Thomas located?

Robert Thomas practices at 123 N 19th St Suite B301, Middlesboro, KY 40965. The listed phone number is (606) 248-7509.

What is Robert Thomas's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Robert Thomas enrolled in Medicare?

Yes. Robert Thomas 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.

What insurance does Robert Thomas accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health and Ambetter of Tennessee list Robert Thomas 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 Robert Thomas affiliated with any hospitals?

According to CMS data, Robert Thomas is affiliated with Middlesboro Arh Hospital.

When was this NPI record last updated?

The NPPES record for Robert Thomas was last updated on April 17, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.