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DR. KARL F HEINSS MD
NPI 1992705362
Internal Medicine in Corbin, KY

Active since July 28, 2005PECOS EnrolledAccepts Medicare Assignment
95.5/100
CMS Quality Rating
2 TRILLIUM WAY, SUITE 306, CORBIN, KY 40701(606) 526-4070(606) 526-4072 Get Directions Write a Review

NPPES record last updated: December 4, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 4, 2020, Feb 5, 2016 (2 updates tracked since 2016).

About Dr. Karl F Heinss Md NPPES

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

DR. KARL F HEINSS MD (NPI 1992705362) is an individual internal medicine provider in Corbin, Kentucky, licensed in Kentucky (29004) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Saint Joseph London, and is a graduate of East Tennessee State University Quillen College Of Medicine (1991).

NPPES Registry Identity

NPI1992705362
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. KARL F HEINSSCredential: MD
Location Address2 TRILLIUM WAY, SUITE 306Corbin, KY 40701-8490
Mailing AddressPo Box 1325Corbin, KY 40702-1325 · (606) 526-8131 · Fax (606) 528-8661
Phone(606) 526-4070
Fax(606) 526-4072
Sole ProprietorYes
Medical School CMSEast Tennessee State University Quillen College Of MedicineGraduated 1991
Enumeration DateJuly 28, 2005
Last NPPES UpdateDecember 4, 20202 updates tracked since enumeration
NPPES CertifiedDecember 4, 2020
✔ NPI 1992705362 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 · 29004
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.
2 TRILLIUM WAY, Corbin, KY 40701
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Other Identifiers 2

Medicaid64290042KY
OtherP01329444KY · Rr Medicare

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

Dr. Karl F Heinss 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 ID4486718012
PECOS Enrollment IDI20090127000376
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 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.
316 services100 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.
170 services73 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.
55 services54 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.
27 services27 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.
22 services22 patients

Hospital Affiliations CMS Care Compare 4

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

Saint Joseph London

Acute Care Hospitals · London, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180011
Location1001 Saint Joseph LaneLondon, KY 40741 · Laurel County
Emergency services Birthing friendly

Manchester Memorial Hospital

Acute Care Hospitals · Manchester, KY
OwnershipVoluntary non-profit - Church
CMS Certification Number180043
Location210 Marie Langdon DriveManchester, KY 40962 · Clay County
Emergency services Birthing friendly

University Of Kentucky Hospital

Acute Care Hospitals · Lexington, KY
3/5 CMS rating
OwnershipGovernment - State
CMS Certification Number180067
Location800 Rose StreetLexington, KY 40536 · Fayette County
Emergency services Birthing friendly

Baptist Health Corbin

Acute Care Hospitals · Corbin, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180080
LocationOne Trillium WayCorbin, KY 40701 · Whitley County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40701 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.

95.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality89.59
Promoting Interoperability100
Improvement Activities40

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
3 suppliers22 claims22 services$19.39 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
3 suppliers24 claims24 services$103.58 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 9

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

AMANDA MARIE BRANDON PA-C
Physician Assistant
2 TRILLIUM WAY, SUITE 306
CORBIN, KY 40701
Whitley County (606) 526-4070
CHRISTOPHER A TROXELL D.O.
Internal Medicine
2 TRILLIUM WAY, SUITE 306
CORBIN, KY 40701
Whitley County (606) 526-4070
ALLYSON E O'KUMA PA-C
Physician Assistant
2 TRILLIUM WAY, STE. 306
CORBIN, KY 40701
Whitley County (606) 526-4070
DR. JOHNNY BRUCE HAMMONS II MD
Hospitalist
2 TRILLIUM WAY, SUITE 306
CORBIN, KY 40701
Whitley County (606) 526-4070
DR. RAY G HAYS III MD
Hospitalist
2 TRILLIUM WAY, SUITE 306
CORBIN, KY 40701
Whitley County (606) 526-4070
DR. AIMEE RUSSELL GRACE DO
Internal Medicine
2 TRILLIUM WAY, SUITE 306
CORBIN, KY 40701
Whitley County (606) 526-4070
MR. WILLIAM K GILBERT PA-C
Physician Assistant (Medical)
2 TRILLIUM WAY, STE. 306
CORBIN, KY 40701
Whitley County (606) 526-4070
DR. JIMMYE SHANNON PERKINS M.D.
Internal Medicine
2 TRILLIUM WAY, SUITE 306
CORBIN, KY 40701
Whitley County (606) 526-4070

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 Karl Heinss's NPI number?

The NPI number for Karl Heinss is 1992705362. It was assigned to this individual provider in the NPPES registry on July 28, 2005.

Where is Karl Heinss located?

Karl Heinss practices at 2 Trillium Way Suite 306, Corbin, KY 40701. The listed phone number is (606) 526-4070.

What is Karl Heinss's specialty?

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

Is Karl Heinss enrolled in Medicare?

Yes. Karl Heinss 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 Karl Heinss accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and CareSource list Karl Heinss 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 Karl Heinss affiliated with any hospitals?

According to CMS data, Karl Heinss is affiliated with Saint Joseph London, Manchester Memorial Hospital, University Of Kentucky Hospital and Baptist Health Corbin.

When was this NPI record last updated?

The NPPES record for Karl Heinss was last updated on December 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.