Active NPI
Gerald W. Elliott, M.D.
- Dermatology Physician
- Lexington, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 26524
- Practice address
- 120 N Eagle Creek Dr
Suite 360
Lexington, KY 40509-1827 - Phone
- (859) 258-5270
- Fax
- (859) 258-5202
- NPI assigned
- Jul 11, 2006
- Last updated
- Nov 2, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 26524 | KY | Primary |
| Pediatric Dermatology Physician | 207NP0225X | 26524 | KY | |
| Procedural Dermatology Physician | 207NS0135X | 26524 | KY |
Addresses
Primary practice location
120 N Eagle Creek Dr
Suite 360
Lexington, KY 40509-1827
Mailing address
120 N Eagle Creek Dr
Suite 360
Lexington, KY 40509-1827
Phone (859) 258-5270
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CB5773 | Other | KY | RAILROAD MEDICARE GROUP |
| 37903705 | Other | KY | MEDICAID LAB GROUP |
| 64265242 | Medicaid | KY | |
| ASC1019 | Other | KY | ASC MEDICARE GROUP |
| 36000818 | Other | KY | ASC MEDICAID LAB GROUP |
| 4000501 | Other | KY | MEDICARE LAB GROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- University of Louisville School of Medicine, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
120 N Eagle Creek Dr
Suite 360
Lexington, KY 40509-1827
Phone (859) 258-5270
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 1287 |
| Removal or shaving of skin growth | 56 |
| Skin biopsy | 69 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26524 | KY | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Lexington Clinic PSC | Current | Accepting new patients | |
| New Lexington Clinic, PSC | Current | Accepting new patients |
Locations
120 N Eagle Creek Dr
Ste 360
Lexington, KY 40509
Phone (859) 258-5270
1221 S Broadway
Lexington, KY 40504
Phone (859) 258-4181
Interoperability endpoints
- gerald.elliott.1@13059.direct.athenahealth.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Lexington Clinic
- Multi-Specialty Clinic/Center
- Lexington, KY
- NPI 1700803681
-
- Clinical Medical Laboratory
- Lexington, KY
- NPI 1285409425
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193961600000",
"number": "1225063175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 N EAGLE CREEK DR",
"address_2": "SUITE 360",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405091827",
"telephone_number": "859-258-5270",
"fax_number": "859-258-5202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 N EAGLE CREEK DR",
"address_2": "SUITE 360",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405091827",
"telephone_number": "859-258-5270",
"fax_number": "859-258-5202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "GERALD",
"middle_name": "W.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2007-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "KY",
"license": "26524",
"primary": true
},
{
"code": "207NP0225X",
"taxonomy_group": "",
"desc": "Dermatology, Pediatric Dermatology",
"state": "KY",
"license": "26524",
"primary": false
},
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": "KY",
"license": "26524",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE GROUP",
"identifier": "CB5773",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID LAB GROUP",
"identifier": "37903705",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64265242",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASC MEDICARE GROUP",
"identifier": "ASC1019",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASC MEDICAID LAB GROUP",
"identifier": "36000818",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE LAB GROUP",
"identifier": "4000501",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.