LOY VAUGHAN
NPI 1639532146
Orthopaedic Surgery in Pelham, AL

Q: 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.

Q: What is Loy Vaughan's specialty?

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

Q: 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.

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: October 25, 2026.

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

On this page

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

Phone(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

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama, Oscar Insurance Company, UnitedHealthcare.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

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.

Medicare Billing Reassignment

Medicare enrollment records show Loy Vaughan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Alabama Bone & Joint Clinic,llc

Same address

Orthopaedic Surgery

120 CAHABA VALLEY PKWY STE 100
Pelham, AL 35124

Reassigned Medicare billing, Alabama enrollment
7 clinicians in this Medicare group

NPI 1780980540 (205) 621-3778

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 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

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

28 services25 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.

28 services28 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

26 services16 patients

X-ray of shoulder blade 73010

An X-ray of the shoulder blade is a quick, painless test that produces images of the bones in your shoulder area. It helps identify fractures, infections, or other abnormalities. You'll need to stay still while a machine sends a small amount of radiation through your shoulder to capture the image.

25 services19 patients

X-ray of lower and sacral spine, minimum of 4 views 72110

An X-ray of the lower and sacral spine involves capturing images of your lower back and tailbone area. It helps in identifying issues like fractures, arthritis, or other abnormalities. At least four different angles or 'views' are taken to get a comprehensive picture.

20 services18 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

17 services14 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.

15 services15 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.

14 services14 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

Quality

81.25

Improvement Activities

Cost

Other Providers at the Same Location NPPES 7

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

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