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RICHARD A HEFNER D.O.
NPI 1639102585
Family Medicine in Crestwood, KY

Active since July 07, 2006PECOS EnrolledAccepts Medicare Assignment
95.5/100
CMS Quality Rating
6580 KENWOOD CROSSINGS ROAD, CRESTWOOD, KY 40014(502) 243-3161(502) 243-3164 Get Directions Write a Review

NPPES record last updated: December 4, 2020. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Richard A Hefner D.o. NPPES

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

RICHARD A HEFNER D.O. (NPI 1639102585) is an individual family medicine provider in Crestwood, Kentucky, licensed in Kentucky (02614) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Jewish Hospital & St Mary's Healthcare, and is a graduate of College Of Osteo Med Of The Pacific At Pomona (1984).

NPPES Registry Identity

NPI1639102585
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameRICHARD A HEFNERCredential: D.O.
Location Address6580 KENWOOD CROSSINGS ROADCrestwood, KY 40014
Mailing AddressPo Box 950248Louisville, KY 40295-0248 · (502) 253-1035 · Fax (502) 253-1037
Phone(502) 243-3161
Fax(502) 243-3164
Sole ProprietorNo
Medical School CMSCollege Of Osteo Med Of The Pacific At PomonaGraduated 1984
Enumeration DateJuly 7, 2006
Last NPPES UpdateDecember 4, 2020
NPPES CertifiedDecember 4, 2020
✔ NPI 1639102585 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in KY · 02614
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
6580 KENWOOD CROSSINGS ROAD, Crestwood, KY 40014
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Other Identifiers 5

Other000000609332KY · Anthem
Other50023695KY · Passport
OtherP00774983KY · Railroad Medicare
Medicaid64000391KY
Other3711039000KY · Passport Advantage

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 and accepts Medicare assignment

Richard A Hefner D.o. 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 ID840396214
PECOS Enrollment IDI20070501000327
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 5

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.
293 services186 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.
236 services169 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
172 services172 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
21 services21 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
20 services20 patients

Hospital Affiliations CMS Care Compare 3

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

Jewish Hospital & St Mary's Healthcare

Acute Care Hospitals · Louisville, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180040
Location200 Abraham Flexner WayLouisville, KY 40202 · Jefferson County
Emergency services

Baptist Health Louisville

Acute Care Hospitals · Louisville, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180130
Location4000 Kresge WayLouisville, KY 40207 · Jefferson County
Emergency services Birthing friendly

Baptist Health Lagrange

Acute Care Hospitals · La Grange, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180138
Location1025 New Moody LaneLa Grange, KY 40031 · Oldham County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40014 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
$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.

95.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality89.59
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 6

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
8 suppliers24 claims51 services$6.23 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
2 suppliers23 claims23 services$51.98 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
2 suppliers15 claims900 services$4.93 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
3 suppliers20 claims1,530 services$0.84 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
1 supplier12 claims63,000 services$0.15 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
3 suppliers19 claims19 services$26.16 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Richard Hefner's NPI number?

The NPI number for Richard Hefner is 1639102585. It was assigned to this individual provider in the NPPES registry on July 7, 2006.

Where is Richard Hefner located?

Richard Hefner practices at 6580 Kenwood Crossings Road, Crestwood, KY 40014. The listed phone number is (502) 243-3161.

What is Richard Hefner's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Richard Hefner enrolled in Medicare?

Yes. Richard Hefner 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 Richard Hefner accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and CareSource list Richard Hefner 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 Richard Hefner affiliated with any hospitals?

According to CMS data, Richard Hefner is affiliated with Jewish Hospital & St Mary's Healthcare, Baptist Health Louisville and Baptist Health Lagrange.

When was this NPI record last updated?

The NPPES record for Richard Hefner was last updated on December 4, 2020. 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.