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TONYA E SHEA DO
NPI 1740674522
Family Medicine in Somerset, KY

Active since March 19, 2015PECOS Enrolled
350 HOSPITAL WAY, SUITE 101, SOMERSET, KY 42503(606) 451-5092 Get Directions Write a Review

NPPES record last updated: September 7, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Tonya E Shea Do NPPES

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

TONYA E SHEA DO (NPI 1740674522) is an individual family medicine provider in Somerset, Kentucky, licensed in Kentucky (04164) and active in the NPI registry since March 2015. She is enrolled in Medicare PECOS, is affiliated with T J Samson Community Hospital, and maintains a secondary practice location in Somerset.

NPPES Registry Identity

NPI1740674522
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameTONYA E SHEACredential: DO
Location Address350 HOSPITAL WAY, SUITE 101Somerset, KY 42503
Mailing Address350 Hospital Way, Ste 100Somerset, KY 42503-1872
Phone(606) 451-5092
Sole ProprietorNo
Medical School CMSUniversity Of Pikeville, Kentucky College Of Osteopathic MedGraduated 2015
Enumeration DateMarch 19, 2015
Last NPPES UpdateSeptember 7, 2018
✔ NPI 1740674522 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in KY · 04164
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
350 HOSPITAL WAY, Somerset, KY 42503
Open in Google Maps ↗

Other Names 1

Former Name (1)Tonya E Morgan

Secondary Practice Location 1

Location 1350 Hospital Way Ste 100Somerset, KY 42503-1872 · Phone (606) 451-2600 · Fax (606) 451-2622

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 and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tonya E Shea Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID941588578
PECOS Enrollment IDI20181005002129
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

5

Medicare enrollment records show Tonya Shea reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lake Cumberland Regional Hospital, LLC
Same address
Internal Medicine
350 HOSPITAL WAY, SUITE 100
Somerset, KY 42503
  • Reassigned Medicare billing, Kentucky enrollment
  • 89 clinicians in this Medicare group
NPI 1447330451 (606) 451-2619
Russell County Hospital
31 mi
Nurse Anesthetist, Certified Registered
153 DOWELL RD
Russell Springs, KY 42642
  • Reassigned Medicare billing, Kentucky enrollment
  • Also billed through NPI 1013954437 (Kentucky)
  • 47 clinicians in this Medicare group
NPI 1437245842 (270) 866-4141
Telos Health Systems Ky LLC
92 mi
Mental Health
3500 GOOD SAMARITAN WAY
Louisville, KY 40299
  • Reassigned Medicare billing, Kentucky enrollment
  • Medicare enrollment name: Vitae Health Medical Kentucky, LLC
  • 68 clinicians in this Medicare group
NPI 1629600879 (201) 217-6777
Cardinal Health PLLC
97 mi
Family Medicine
9600 LAMBORNE BLVD
Louisville, KY 40272
  • Reassigned Medicare billing, Kentucky enrollment
  • 20 clinicians in this Medicare group
NPI 1265384077 (385) 207-9919
Provider Partners Care Management LP
443 mi
Nurse Practitioner
8820 COLUMBIA 100 PKWY STE 430
Columbia, MD 21045
  • Reassigned Medicare billing, Kentucky enrollment
  • 100 clinicians in this Medicare group
NPI 1013348028 (443) 275-9800

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 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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
145 services55 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.
80 services74 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
46 services44 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
36 services21 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
25 services25 patients

Hospital Affiliations CMS Care Compare 4

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

T J Samson Community Hospital

Acute Care Hospitals · Glasgow, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number180017
Location1301 North Race StreetGlasgow, KY 42141 · Barren 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

Wayne County Hospital

Critical Access Hospitals · Monticello, KY
OwnershipVoluntary non-profit - Private
CMS Certification Number181321
Location166 Hospital StreetMonticello, KY 42633 · Wayne County
Emergency services

Russell County Hospital

Critical Access Hospitals · Russell Springs, KY
OwnershipGovernment - Local
CMS Certification Number181330
Location153 Dowell RoadRussell Springs, KY 42642 · Russell County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 42503 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.

Referred Medical Equipment & Supplies CMS DME claims 7

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 suppliers26 claims63 services$6.46 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
3 suppliers18 claims18 services$64.97 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers15 claims16 services$19.99 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
3 suppliers23 claims23 services$7.92 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
1 supplier13 claims13 services$34.92 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
4 suppliers39 claims39 services$116.19 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

DR. AMR OSMAN EL-NAGGAR M.D.
Neurological Surgery
350 HOSPITAL WAY, SUITE 270
SOMERSET, KY 42503
Pulaski County (606) 678-9617
MR. RAINER ALLEN OLIVER DO
Internal Medicine
350 HOSPITAL WAY, SUITE 101
SOMERSET, KY 42503
Pulaski County (606) 451-5093
DAVID M REILLY M.D.
Family Medicine
350 HOSPITAL WAY, SUITE 100
SOMERSET, KY 42503
Pulaski County (606) 451-2601
JOSEPH G WEIGEL M.D.
Internal Medicine
350 HOSPITAL WAY, SUITE 100
SOMERSET, KY 42503
Pulaski County (606) 451-2629
MISS SUSAN MICHELE PELL ATC, PA-C
Physician Assistant
350 HOSPITAL WAY, SUITE 100
SOMERSET, KY 42503
Pulaski County (606) 451-2628
LAKE CUMBERLAND REGIONAL HOSPITAL, LLC
Thoracic Surgery (Cardiothoracic Vascular Surgery)
350 HOSPITAL WAY, SUITE 220
SOMERSET, KY 42503
Pulaski County (606) 451-0300
LAKE CUMBERLAND REGIONAL HOSPITAL LLC
Internal Medicine (Pulmonary Disease)
350 HOSPITAL WAY, SUITE 250
SOMERSET, KY 42503
Pulaski County (606) 678-0171
RICHARD F ATKINSON
Student in an Organized Health Care Education/Training Program
350 HOSPITAL WAY
SOMERSET, KY 42503
Pulaski County (630) 291-6874

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 Tonya Shea's NPI number?

The NPI number for Tonya Shea is 1740674522. It was assigned to this individual provider in the NPPES registry on March 19, 2015. The provider is also known as Tonya E Morgan.

Where is Tonya Shea located?

Tonya Shea practices at 350 Hospital Way Suite 101, Somerset, KY 42503. The listed phone number is (606) 451-5092.

What is Tonya Shea's specialty?

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

Is Tonya Shea enrolled in Medicare?

Yes. Tonya Shea is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Tonya Shea's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tonya Shea reassigns Medicare benefits to 5 organizations: Lake Cumberland Regional Hospital, LLC (Somerset, KY), Russell County Hospital (Russell Springs, KY), Telos Health Systems Ky LLC (Louisville, KY), Cardinal Health PLLC (Louisville, KY) and Provider Partners Care Management LP (Columbia, MD). 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 Tonya Shea's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Tonya Shea accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield list Tonya Shea 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 Tonya Shea affiliated with any hospitals?

According to CMS data, Tonya Shea is affiliated with T J Samson Community Hospital, Lake Cumberland Regional Hospital, Wayne County Hospital and Russell County Hospital.

When was this NPI record last updated?

The NPPES record for Tonya Shea was last updated on September 7, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.