1. Home
  2. Directory
  3. Kentucky
  4. Lexington
  5. Pathology
  6. NPI Profile

SHEILA COMBS MD
NPI 1730119124
Pathology - Anatomic Pathology & Clinical Pathology in Lexington, KY

Active since July 03, 2006PECOS EnrolledAccepts Medicare Assignment
97.4/100
CMS Quality Rating
290 BIG RUN RD, LEXINGTON, KY 40503(859) 278-9513 Get Directions Write a Review

NPPES record last updated: November 15, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Sheila Combs Md NPPES

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

SHEILA COMBS MD (NPI 1730119124) is an individual anatomic pathology & clinical pathology provider in Lexington, Kentucky, licensed in Kentucky (31518) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, is affiliated with Saint Joseph Hospital, and is a graduate of University Of Kentucky College Of Medicine (1995).

NPPES Registry Identity

NPI1730119124
Entity TypeIndividualFemale
Primary Taxonomy207ZP0102X
Provider Legal NameSHEILA COMBSCredential: MD
Location Address290 BIG RUN RDLexington, KY 40503-2903
Mailing Address290 Big Run RdLexington, KY 40503-2903 · (859) 278-9513
Phone(859) 278-9513
Sole ProprietorYes
Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 1995
Enumeration DateJuly 3, 2006
Last NPPES UpdateNovember 15, 2022
NPPES CertifiedNovember 15, 2022
✔ NPI 1730119124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
License✔ Licensed in KY · 31518
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
290 BIG RUN RD, Lexington, KY 40503
Open in Google Maps ↗

Other Identifiers 2

Other220027966Railroad
Medicaid65901423KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee.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

Sheila Combs 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 ID2860448230
PECOS Enrollment IDI20050329000740
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

2

Medicare enrollment records show Sheila Combs reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Chipps, Caffrey & Dubilier, P.S.C
Same address
Anatomic Pathology & Clinical Pathology
290 BIG RUN RD
Lexington, KY 40503
  • Reassigned Medicare billing, Kentucky enrollment
  • 21 clinicians in this Medicare group
NPI 1336148683 (859) 278-9513
Appalachian Regional Healthcare, Inc.
69 mi
Rural Health
1084 HIGHWAY 7, SUITE 2
West Liberty, KY 41472
  • Reassigned Medicare billing, Kentucky enrollment
  • 419 clinicians in this Medicare group
NPI 1780043927 (606) 743-3065

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 7

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.

Pathology examination of tissue using a microscope, intermediate complexity 88305
A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.
700 services301 patients
Special stained specimen slides to examine tissue, each additional procedure 88341
Special stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.
65 services23 patients
Pathology examination of tissue using a microscope, moderately low complexity 88304
A pathology examination of tissue, moderately low complexity, involves studying a small sample of your body tissue under a microscope. It helps to identify any abnormal cells or diseases. It's a routine procedure, not complex, and provides crucial insights for your diagnosis.
59 services53 patients
Special stained specimen slides to examine tissue, initial procedure 88342
This procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.
48 services43 patients
Pathology examination of tissue using a microscope, moderately high complexity 88307
A pathology examination of tissue with moderate complexity involves a detailed study of a small tissue sample from your body. Using a microscope, experts analyze the tissue's structure and cells to identify any abnormalities. This helps in diagnosing various health conditions accurately.
44 services29 patients
Preparation of tissue for examination by removing any calcium present 88311
This procedure involves treating tissue samples to remove any calcium, which can interfere with the examination. The tissue is soaked in a special solution that safely dissolves the calcium, leaving the tissue intact for accurate analysis. This helps in making precise diagnoses.
27 services23 patients

Hospital Affiliations CMS Care Compare 5

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

Saint Joseph Hospital

Acute Care Hospitals · Lexington, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number180010
LocationOne Saint Joseph DriveLexington, KY 40504 · Fayette County
Emergency services

Hazard Arh Regional Medical Center

Acute Care Hospitals · Hazard, KY
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180029
Location100 Medical Center DriveHazard, KY 41701 · Perry County
Emergency services Birthing friendly

Baptist Health Richmond

Acute Care Hospitals · Richmond, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180049
Location801 Eastern BypassRichmond, KY 40475 · Madison County
Emergency services Birthing friendly

Baptist Health Lexington

Acute Care Hospitals · Lexington, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number180103
Location1740 Nicholasville RoadLexington, KY 40503 · Fayette County
Emergency services Birthing friendly

Lake Cumberland Regional Hospital

Acute Care Hospitals · Somerset, KY
2/5 CMS rating
OwnershipProprietary
CMS Certification Number180132
Location305 Langdon StreetSomerset, KY 42503 · Pulaski County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40503 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
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
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.

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 20

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

ALEXANDER PATRICK SMITH
Pathology (Anatomic Pathology & Clinical Pathology)
290 BIG RUN RD
LEXINGTON, KY 40503
Fayette County (859) 278-9513
P & C LABS, LLC
Clinical Medical Laboratory
290 BIG RUN RD
LEXINGTON, KY 40503
Fayette County (859) 278-9513
DR. MICHAEL S GRAFF M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
290 BIG RUN RD
LEXINGTON, KY 40503
Fayette County (859) 278-9513
DR. RICHARD LOZANO M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
290 BIG RUN RD
LEXINGTON, KY 40503
Fayette County (859) 278-9513
CHIPPS, CAFFREY & DUBILIER, P.S.C
Pathology (Anatomic Pathology & Clinical Pathology)
290 BIG RUN RD
LEXINGTON, KY 40503
Fayette County (859) 278-9513
DR. JOHN F JANSEN M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
290 BIG RUN RD
LEXINGTON, KY 40503
Fayette County (859) 278-9513
DR. ALLEN CHUKWUEMEKENIM OMO-OGBOI MD
Pathology (Anatomic Pathology & Clinical Pathology)
290 BIG RUN RD
LEXINGTON, KY 40503
Fayette County (859) 278-9513
DR. TERRY D CLARK M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
290 BIG RUN RD
LEXINGTON, KY 40503
Fayette County (859) 278-9513

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 Sheila Combs's NPI number?

The NPI number for Sheila Combs is 1730119124. It was assigned to this individual provider in the NPPES registry on July 3, 2006.

Where is Sheila Combs located?

Sheila Combs practices at 290 Big Run Rd, Lexington, KY 40503. The listed phone number is (859) 278-9513.

What is Sheila Combs's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is Sheila Combs enrolled in Medicare?

Yes. Sheila Combs 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 Sheila Combs's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sheila Combs reassigns Medicare benefits to 2 organizations: Chipps, Caffrey & Dubilier, P.S.C (Lexington, KY) and Appalachian Regional Healthcare, Inc. (West Liberty, KY). 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 Sheila Combs's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sheila Combs accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter of Tennessee list Sheila Combs 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 Sheila Combs affiliated with any hospitals?

According to CMS data, Sheila Combs is affiliated with Saint Joseph Hospital, Hazard Arh Regional Medical Center, Baptist Health Richmond, Baptist Health Lexington and Lake Cumberland Regional Hospital.

When was this NPI record last updated?

The NPPES record for Sheila Combs was last updated on November 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.