TOMMY WARREN SHELTON M.D.
NPI 1770617854
Surgery in Somerset, KY

Q: What is Tommy Shelton's NPI number?

The NPI number for Tommy Shelton is 1770617854. It was assigned to this individual provider in the NPPES registry on March 14, 2007.

Q: What is Tommy Shelton's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for Tommy Shelton was last updated on January 9, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 14, 2007PECOS EnrolledAccepts Medicare Assignment

74.44/100

CMS Quality Rating

350 HOSPITAL WAY, SUITE 270, SOMERSET, KY 42503(606) 425-4298(606) 425-4299 Get Directions Write a Review

NPPES record last updated: January 9, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Tommy Warren Shelton M.d. NPPES

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

TOMMY WARREN SHELTON M.D. (NPI 1770617854) is an individual surgery provider in Somerset, Kentucky, licensed in Kentucky (41582) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS, is affiliated with Lake Cumberland Regional Hospital, and is a graduate of University Of Kentucky College Of Medicine (2002).

NPPES Registry Identity

NPI1770617854

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameTOMMY WARREN SHELTONCredential: M.D.

Location Address350 HOSPITAL WAY, SUITE 270Somerset, KY 42503-2872

Mailing Address350 Hospital Way, Suite 270Somerset, KY 42503-2872 · (606) 425-4298 · Fax (606) 425-4299

Phone(606) 425-4298

Fax(606) 425-4299

Sole ProprietorYes

Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 2002

Enumeration DateMarch 14, 2007

Last NPPES UpdateJanuary 9, 2012

✔ NPI 1770617854 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in KY · 41582

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

350 HOSPITAL WAY, Somerset, KY 42503

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Other Identifiers 1

Other00675001KY · Medicare Ptan

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

Tommy Warren Shelton M.d. 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 ID9234202326

PECOS Enrollment IDI20080723000317

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 10

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, 20-29 minutes 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.

126 services113 patients

Established patient office or other outpatient visit, 10-19 minutes 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

75 services56 patients

New patient office or other outpatient visit, 30-44 minutes 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.

60 services60 patients

Established patient office or other outpatient visit, 30-39 minutes 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.

19 services18 patients

Initial hospital inpatient care per day, typically 50 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

13 services13 patients

New patient office or other outpatient visit, 15-29 minutes 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

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

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

$66.24 typical visit price

range $16.53 – $131.99

Typical copayment $16.56 (range $4.13 – $32.99)

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.

74.44/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

55.1

Promoting Interoperability

Improvement Activities

Reported Quality Measures

Advance Care Plan

69%293 patients3/55-star benchmark: 100%

Age Appropriate Screening Colonoscopy

Lower rates are better for this measure.

1%399 patients

Breast Cancer Screening

21%214 patients1/55-star benchmark: 100%

Colorectal Cancer Screening

19%549 patients1/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

95%1,300 patients3/55-star benchmark: 100%

e-Prescribing

94%114 patients3/55-star benchmark: 100%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

99%707 patients4/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

70%348 patients3/55-star benchmark: 100%

Screening for Osteoporosis for Women Aged 65-85 Years of Age

15%133 patients1/55-star benchmark: 98%

Support Electronic Referral Loops By Sending Health Information

40%103 patients2/55-star benchmark: 100%

Surgical Site Infection (SSI)

Lower rates are better for this measure.

1%182 patients

Unplanned Hospital Readmission within 30 Days of Principal Procedure

Lower rates are better for this measure.

5%22 patients3/55-star benchmark: 100%

Unplanned Reoperation within the 30 Day Postoperative Period

Lower rates are better for this measure.

1%181 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers22 claims22 services$20.32 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

2 suppliers22 claims22 services$109.45 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

RODNEY J OAKES M.D.

Family Medicine