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ANTHONY C STUMBO MD
NPI 1780769422
Internal Medicine in Prestonsburg, KY

Active since October 25, 2006PECOS EnrolledAccepts Medicare Assignment
97.4/100
CMS Quality Rating
5000 KY RT 321, SUITE 3102, PRESTONSBURG, KY 41653(606) 886-7645(606) 886-7427 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Anthony C Stumbo Md NPPES

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

ANTHONY C STUMBO MD (NPI 1780769422) is an individual internal medicine provider in Prestonsburg, Kentucky, licensed in Kentucky (27494) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Highlands Arh Regional Medical Center, and is a graduate of University Of Louisville School Of Medicine (1989).

NPPES Registry Identity

NPI1780769422
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameANTHONY C STUMBOCredential: MD
Location Address5000 KY RT 321, SUITE 3102Prestonsburg, KY 41653
Mailing AddressPo Box 72Prestonsburg, KY 41653 · (606) 886-7645 · Fax (606) 886-7427
Phone(606) 886-7645
Fax(606) 886-7427
Sole ProprietorNo
Medical School CMSUniversity Of Louisville School Of MedicineGraduated 1989
Enumeration DateOctober 25, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1780769422 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in KY · 27494
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
5000 KY RT 321, Prestonsburg, KY 41653
Open in Google Maps ↗

Other Identifiers 3

Medicare UPINE83699
Medicare ID-Type Unspecified0747102
Medicaid64274947KY

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

Anthony C Stumbo 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 ID9931121696
PECOS Enrollment IDI20051221000740
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.

Hospital Affiliations CMS Care Compare

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

Highlands Arh Regional Medical Center

Acute Care Hospitals · Prestonsburg, KY
2/5 CMS rating
OwnershipProprietary
CMS Certification Number180005
Location5000 Kentucky Route 321Prestonsburg, KY 41653 · Floyd County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41653 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

Reported Quality Measures

Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
86%249 patients4/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%2,859 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
47%3,321 patients1/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
52%540 patients3/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
99%678 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
21%563 patients1/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 96% · 741 patients
Patients tobacco: 92% · 741 patients
62%69 patients3/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%563 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
24%563 patients2/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
10%563 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 15

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
12 suppliers65 claims174 services$6.05 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
2 suppliers12 claims12 services$2.94 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
6 suppliers30 claims38 services$1.18 avg. paid by Medicare
Tracheostomy, inner cannula A4623
DME-Orthotic Devices · category DF000N
1 supplier11 claims660 services$5.38 avg. paid by Medicare
Tracheal suction catheter, any type other than closed system, each A4624
DME-Other DME · category DE000N
1 supplier11 claims336 services$2.17 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
1 supplier11 claims22 services$2.00 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 2

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

EASTERN KENTUCKY IMAGING, PSC
Radiology (Diagnostic Radiology)
5000 KY RT 321, RADIOLOGY DEPARTMENT
PRESTONSBURG, KY 41653
Floyd County (606) 836-4929
INTERNAL MEDICINE OF EASTERN KENTUCKY PLLC
Internal Medicine
5000 KY RT 321, SUITE 3102
PRESTONBURG, KY 41653
Floyd County (606) 886-7645

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 Anthony Stumbo's NPI number?

The NPI number for Anthony Stumbo is 1780769422. It was assigned to this individual provider in the NPPES registry on October 25, 2006.

Where is Anthony Stumbo located?

Anthony Stumbo practices at 5000 Ky Rt 321 Suite 3102, Prestonsburg, KY 41653. The listed phone number is (606) 886-7645.

What is Anthony Stumbo's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Anthony Stumbo enrolled in Medicare?

Yes. Anthony Stumbo 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.

What insurance does Anthony Stumbo accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health and Ambetter of Tennessee list Anthony Stumbo 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 Anthony Stumbo affiliated with any hospitals?

According to CMS data, Anthony Stumbo is affiliated with Highlands Arh Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Anthony Stumbo was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.