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

DR. DAVID ANTHONY HAMILTON JR. M.D., M.B.A.
NPI 1811257561
Orthopaedic Surgery in Lexington, KY

Active since May 29, 2012PECOS EnrolledAccepts Medicare Assignment
83.31/100
CMS Quality Rating
160 N EAGLE CREEK DR, LEXINGTON, KY 40509(859) 264-9820(859) 543-0994 Get Directions Write a Review

NPPES record last updated: March 17, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 17, 2026, May 7, 2021, Mar 23, 2020 and 2 more (5 updates tracked since 2019).

About Dr. David Anthony Hamilton Jr. M.d., M.b.a. NPPES

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

DR. DAVID ANTHONY HAMILTON JR. M.D., M.B.A. (NPI 1811257561) is an individual orthopaedic surgery provider in Lexington, Kentucky, licensed in Kentucky (52644) and active in the NPI registry since May 2012. He is enrolled in Medicare PECOS, is affiliated with Clark Regional Medical Center, and maintains a secondary practice location in Lexington.

NPPES Registry Identity

NPI1811257561
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. DAVID ANTHONY HAMILTON JR.Credential: M.D., M.B.A.
Location Address160 N EAGLE CREEK DRLexington, KY 40509-2121
Mailing AddressPo Box 936London, KY 40743-0936 · (606) 330-7835 · Fax (859) 543-0994
Phone(859) 264-9820
Fax(859) 543-0994
Sole ProprietorNo
Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 2011
Enumeration DateMay 29, 2012
Last NPPES UpdateMarch 17, 20265 updates tracked since enumeration
NPPES CertifiedMarch 17, 2026
✔ NPI 1811257561 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Licenses✔ Licensed in KY · 52644✔ Licensed in KY · R3102
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
160 N EAGLE CREEK DR, Lexington, KY 40509
Open in Google Maps ↗

Secondary Practice Location 1

Location 1216 Fountain Ct Ste 250Lexington, KY 40509-2510 · Phone (859) 276-5008 · Fax (859) 278-6401

Other Identifiers 1

Medicaid7100326260KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Dr. David Anthony Hamilton Jr. M.d., M.b.a. 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 ID5193043503
PECOS Enrollment IDI20190815001983
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

3

Medicare enrollment records show David Hamilton reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ortho Kentucky Dba Kentucky Bone & Joint Surgeons
0.2 mi
Orthopaedic Surgery
216 FOUNTAIN CT STE 250
Lexington, KY 40509
  • Reassigned Medicare billing, Kentucky enrollment
  • Medicare enrollment name: Ortho Kentucky PLLC
  • 9 clinicians in this Medicare group
NPI 1962735621 (859) 276-5008
Kentuckyone Health Medical Group, Inc.
5.2 mi
Family Medicine
1401 HARRODSBURG RD
Lexington, KY 40504
  • Reassigned Medicare billing, Kentucky enrollment
  • 250 clinicians in this Medicare group
NPI 1104875970 (606) 330-7835
Harrison Memorial Hospital Inc
28 mi
Multi-Specialty
1210 KY HIGHWAY 36 E
Cynthiana, KY 41031
  • Reassigned Medicare billing, Kentucky enrollment
  • 81 clinicians in this Medicare group
NPI 1669615233 (859) 234-2300

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 11

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 with low level od decision making, if using time, 20 minutes or more 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.
118 services88 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 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.
107 services81 patients
X-ray of foot, minimum of 3 views 73630
An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.
73 services50 patients
X-ray of ankle, minimum of 3 views 73610
An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.
50 services33 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
50 services29 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 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.
46 services45 patients

Hospital Affiliations CMS Care Compare 3

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

Clark Regional Medical Center

Acute Care Hospitals · Winchester, KY
3/5 CMS rating
OwnershipProprietary
CMS Certification Number180092
Location175 Hospital DriveWinchester, KY 40391 · Clark 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

Saint Joseph East

Acute Care Hospitals · Lexington, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180143
Location150 North Eagle Creek DriveLexington, KY 40509 · Fayette County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40509 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.

83.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality85
Promoting Interoperability100
Improvement Activities40
Cost52.71

Referred Medical Equipment & Supplies CMS DME claims

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

Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf L4361
DME-Orthotic Devices · category DF003N
1 supplier13 claims13 services$227.84 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.

KENTUCKY MOTILITY SERVICES, LLC
Internal Medicine (Gastroenterology)
160 N EAGLE CREEK DR, SUITE 202
LEXINGTON, KY 40509
Fayette County (859) 263-0022
MRS. CHRISTINA DAUGHERTY APRN
Nurse Practitioner (Women's Health)
160 N EAGLE CREEK DR, SUITE 400
LEXINGTON, KY 40509
Fayette County (859) 258-5220
WOMENS GASTROENTEROLOGY CONSULTANTS, PSC
Internal Medicine (Gastroenterology)
160 N EAGLE CREEK DR, SUITE 202
LEXINGTON, KY 40509
Fayette County (859) 263-0022
MATTHEW EARL EADS MD
Orthopaedic Surgery (Hand Surgery)
160 N EAGLE CREEK DR
LEXINGTON, KY 40509
Fayette County (859) 264-9820
KRISTYN J. DULLAGHAN PA-C
Physician Assistant
160 N EAGLE CREEK DR
LEXINGTON, KY 40509
Fayette County (859) 264-9820
MR. LOGAN F. HASKINS PA-C
Physician Assistant
160 N EAGLE CREEK DR
LEXINGTON, KY 40509
Fayette County (859) 264-9820
SAINT JOSEPH HEALTH SYSTEM, INC.
Internal Medicine (Sleep Medicine)
160 N EAGLE CREEK DR, STE 302
LEXINGTON, KY 40509
Fayette County (859) 967-5044
COMMONWEALTH UROLOGY, PSC
Specialist
160 N EAGLE CREEK DR, SUITE 301
LEXINGTON, KY 40509
Fayette County (859) 737-4411

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 David Hamilton's NPI number?

The NPI number for David Hamilton is 1811257561. It was assigned to this individual provider in the NPPES registry on May 29, 2012.

Where is David Hamilton located?

David Hamilton practices at 160 N Eagle Creek Dr, Lexington, KY 40509. The listed phone number is (859) 264-9820.

What is David Hamilton's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is David Hamilton enrolled in Medicare?

Yes. David Hamilton 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 David Hamilton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), David Hamilton reassigns Medicare benefits to 3 organizations: Ortho Kentucky Dba Kentucky Bone & Joint Surgeons (Lexington, KY), Kentuckyone Health Medical Group, Inc. (Lexington, KY) and Harrison Memorial Hospital Inc (Cynthiana, 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 David Hamilton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does David Hamilton accept?

Health plans from Anthem Blue Cross and Blue Shield list David Hamilton 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 David Hamilton affiliated with any hospitals?

According to CMS data, David Hamilton is affiliated with Clark Regional Medical Center, Baptist Health Lexington and Saint Joseph East.

When was this NPI record last updated?

The NPPES record for David Hamilton was last updated on March 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.