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

Q: 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.

Q: 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.

Q: When was this NPI record last updated?

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

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: July 26, 2026.

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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

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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 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

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.

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 Deaconess Madisonville

Acute Care Hospitals · Madisonville, KY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180093

Location900 Hospital DriveMadisonville, KY 42431 · Hopkins 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

Quality

76.55

Promoting Interoperability

100

Improvement Activities

Leave this field empty

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)