LOY VAUGHAN
NPI 1639532146
Orthopaedic Surgery in Pelham, AL

Active since April 01, 2016PECOS EnrolledAccepts Medicare Assignment
72.7/100
CMS Quality Rating
120 CAHABA VALLEY PKWY STE 100, PELHAM, AL 35124(205) 909-2515 Get Directions Write a Review

NPPES record last updated: June 21, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 21, 2021, Apr 1, 2016 (2 updates tracked since 2016).

About Loy Vaughan NPPES

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

LOY VAUGHAN (NPI 1639532146) is an individual orthopaedic surgery provider in Pelham, Alabama, licensed in Alabama (MD.42663) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS and is a graduate of University Of Alabama School Of Medicine (2012).

NPPES Registry Identity

NPI1639532146
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameLOY VAUGHAN
Location Address120 CAHABA VALLEY PKWY STE 100Pelham, AL 35124-1187
Mailing Address120 Cahaba Valley Pkwy Ste 100Pelham, AL 35124-1187 · (205) 909-2515
Sole ProprietorNo
Medical School CMSUniversity Of Alabama School Of MedicineGraduated 2012
Enumeration DateApril 1, 2016
Last NPPES UpdateJune 21, 20212 updates tracked since enumeration
NPPES CertifiedJune 21, 2021
NPI 1639532146 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License Licensed in AL · MD.42663
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
120 CAHABA VALLEY PKWY STE 100, Pelham, AL 35124

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

Loy Vaughan 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 ID5092000281
PECOS Enrollment IDI20210629001642
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 14

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.
137 services75 patients
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702
This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.
97 services24 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.
67 services42 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
38 services24 patients
X-ray of wrist, minimum of 3 views 73110
An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.
38 services11 patients
X-ray of shoulder, minimum of 2 views 73030
An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.
36 services23 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35124 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
$81.90 typical visit price
range $52.65 – $161.63
Typical copayment $20.47 (range $13.16 – $40.40)
Most-billed visit code 99203
Established Patient
$66.08 typical visit price
range $16.56 – $131.65
Typical copayment $16.52 (range $4.14 – $32.91)
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.

72.7/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.25
Improvement Activities40
Cost34

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.

Nurse Practitioner
120 CAHABA VALLEY PKWY STE 100
PELHAM, AL 35124
Orthopaedic Surgery (Hand Surgery)
120 CAHABA VALLEY PKWY STE 100
PELHAM, AL 35124
Orthopaedic Surgery
120 CAHABA VALLEY PKWY STE 100
PELHAM, AL 35124
Orthopaedic Surgery
120 CAHABA VALLEY PKWY STE 100
PELHAM, AL 35124
Occupational Therapist
120 CAHABA VALLEY PKWY STE 100
PELHAM, AL 35124

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 Loy Vaughan's NPI number?

The NPI number for Loy Vaughan is 1639532146. It was assigned to this individual provider in the NPPES registry on April 1, 2016.

Where is Loy Vaughan located?

Loy Vaughan practices at 120 Cahaba Valley Pkwy Ste 100, Pelham, AL 35124. The listed phone number is (205) 909-2515.

What is Loy Vaughan's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Loy Vaughan enrolled in Medicare?

Yes. Loy Vaughan 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 Loy Vaughan accept?

Health plans from Blue Cross and Blue Shield of Alabama, Oscar Insurance Company and UnitedHealthcare list Loy Vaughan 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 Loy Vaughan was last updated on June 21, 2021. 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.