DR. JOHN E. PAPPAS M.D.
NPI 1922219294
Internal Medicine in Pikeville, KY

NPI Status: Active since May 25, 2007

Contact Information

255 CHURCH ST STE 101
PIKEVILLE, KY
ZIP 41501
Phone: (606) 432-5660

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  • Individual
  • Male
  • Internal Medicine
  • Accepts Insurance
  • PECOS Enrolled

About JOHN PAPPAS

This page provides the complete NPI Profile along with additional information for John Pappas, an internist established in Pikeville, Kentucky with a medical specialization in Internal Medicine. The healthcare provider is registered in the NPI registry with number 1922219294 assigned on May 2007. The practitioner's primary taxonomy code is 207R00000X with license number 17920 (KY). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI
1922219294
Provider Name
DR. JOHN E. PAPPAS M.D.
Gender
Male
Entity Type
Individual
Location Address
255 CHURCH ST STE 101 PIKEVILLE, KY 41501
Location Phone
(606) 432-5660
Mailing Address
354 WALLER AVE SUITE 110 LEXINGTON, KY 40504
Mailing Phone
(859) 225-5672
Mailing Fax
Is Sole Proprietor?
Yes
Enumeration Date
05-25-2007
Last Update Date
03-07-2023
Code Navigator

An internist like John Pappas is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Secondary Locations

  • 354 Waller Ave Suite 110
    Lexington, KY 40504
    (859) 225-5672

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
17920
License State
KY
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207RA0401XAllopathic & Osteopathic Physicians

Internal Medicine
Addiction Medicine

17920 (KY)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Connect 1500 Gold - EPO
  • Connect 6000 Silver - EPO
  • Connect 9800 Bronze - EPO
  • HSA Qualified 7500 Bronze - Choice Network - EPO
  • HSA-E Qualified 7500 Bronze - Signature Network - EPO
  • Providence Oregon Standard Bronze Plan - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Signature Network - EPO
  • Providence Oregon Standard Gold Plan - Choice Network - EPO
  • Providence Oregon Standard Gold Plan - Signature Network - EPO
  • Providence Oregon Standard Silver Plan - Choice Network - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
64179203MEDICAID (05)KY 

Medicare Participation & PECOS Enrollment Status

John Pappas is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 59 times for 11 patients

Testing for presence of drug, read by direct observation

Testing for the presence of drugs involves collecting a sample, usually urine, which is then analyzed for specific substances. The process is monitored directly to ensure accuracy and integrity. This test helps to confirm if drugs are present in your system.

This service was performed 38 times for 11 patients

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 41501 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $122.77
  • Minimum New Patient Price $52.76
  • Maximum New Patient Price $162.27
  • Average New Patient Copayment $30.69
  • Minimum New Patient Copayment $13.19
  • Maximum New Patient Copayment $40.56

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $93.94
  • Minimum Established Patient Price $16.53
  • Maximum Established Patient Price $131.99
  • Average Established Patient Copayment $23.48
  • Minimum Established Patient Copayment $4.13
  • Maximum Established Patient Copayment $32.99

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Reviews for DR. JOHN E. PAPPAS M.D.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1922219294, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
9
Unchanged
Pos 3
2
Doubled → 4
Pos 4
2
Unchanged
Pos 5
2
Doubled → 4
Pos 6
1
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
2
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 2 → 4 9 → 18 → 9 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 9 + 4 + 2 + 4 + 1 + 1 + 8 + 2 + 1 + 8 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1922219294.

Other Providers at the Same Location


The following 15 providers are registered at the same or a nearby location.

Durable Medical Equipment & Medical Supplies
255 CHURCH ST STE 101
PIKEVILLE, KY 41501
Counselor (Professional)
255 CHURCH ST STE 101
PIKEVILLE, KY 41501
Non-Pharmacy Dispensing Site
255 CHURCH ST STE 101
PIKEVILLE, KY 41501
Nurse Practitioner (Family)
255 CHURCH ST STE 101
PIKEVILLE, KY 41501
Nurse Practitioner (Family)
255 CHURCH ST STE 101
PIKEVILLE, KY 41501
General Practice
255 CHURCH ST STE 101
PIKEVILLE, KY 41501
Nurse Practitioner (Family)
255 CHURCH ST STE 101
PIKEVILLE, KY 41501
Nurse Practitioner (Family)
255 CHURCH ST STE 101
PIKEVILLE, KY 41501
Nurse Practitioner
255 CHURCH ST STE 101
PIKEVILLE, KY 41501
Nurse Practitioner (Family)
255 CHURCH ST STE 101
PIKEVILLE, KY 41501
Nurse Practitioner (Family)
255 CHURCH ST STE 101
PIKEVILLE, KY 41501
Family Medicine
255 CHURCH ST STE 101
PIKEVILLE, KY 41501
Nurse Practitioner
255 CHURCH ST STE 101
PIKEVILLE, KY 41501
Nurse Practitioner (Family)
255 CHURCH ST STE 101
PIKEVILLE, KY 41501
Clinic/Center (Rural Health)
255 CHURCH ST STE 101
PIKEVILLE, KY 41501

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1922219294, enumerated as an "individual" on May 25, 2007.

The provider is located at 255 CHURCH ST STE 101 PIKEVILLE, KY 41501 and the phone number is (606) 432-5660.

Internal Medicine with taxonomy code 207R00000X.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.