Active NPI 1932147519 Individual Practitioner Male Practitioner

Dr. Charles A Crumley , MD

Surgery • Middlesboro, KY

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Charles Crumley, MD is a certified Surgery practicing in Middlesboro, KY. With approximately 33 years of clinical experience since graduating from Wright State University Boonshoft School Of Medicine in 1993, Dr. Crumley delivers high-quality medical care to the local community at 3004 CUMBERLAND AVE.

Dr. Crumley maintains professional affiliations with Pineville Community Health Center Inc, Appalachian Regional Healthcare Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

3004 Cumberland Ave

Middlesboro, KY 409652343

Telephone 6062484131

Fax 6062484133

Medicare Profile & Education

Medical School

Wright State University Boonshoft School Of Medicine

Graduation Year

1993

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Middlesboro, KY

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

33 Yrs +6.7 yrs vs City Avg

City Avg: 26.3 Yrs

State Avg: 25.9 Yrs

Regional Practice Density

4 Specialists

Practicing in Middlesboro, KY (495 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

80.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Crumley (33 Years) 33 Yrs

Middlesboro Specialty Average (26.3 Years) 26.3 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	170	101	$49.44	$24.68
99213 Established patient office or other outpatient visit, typically 15 minutes	70	62	$49.00	$48.75
99202 New patient office or other outpatient visit, typically 20 minutes	38	38	$49.00	$48.76
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	37	34	$983.00	$98.81
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	27	27	$71.00	$70.63
45380 Biopsy of large bowel using an endoscope	22	22	$1412.00	$161.48
99213 Established patient office or other outpatient visit, typically 15 minutes	13	12	$49.20	$49.13
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	12	12	$49.20	$24.79

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	98	72	$52.97	$49.48
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	82	55	$51.90	$25.03
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	51	49	$983.00	$92.44
11100 Biopsy of single growth of skin and/or tissue	37	31	$86.99	$47.98
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$75.31	$71.50
45380 Biopsy of large bowel using an endoscope	26	26	$1412.00	$173.47
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	23	22	$49.20	$24.43
99213 Established patient office or other outpatient visit, typically 15 minutes	18	15	$49.20	$48.45
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	14	13	$72.80	$71.81
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	13	13	$135.63	$122.52
11101 Biopsy of each additional growth of skin and/or tissue	12	11	$48.00	$24.12
45378 Diagnostic exam of large bowel using a flexible endoscope	11	11	$1242.00	$182.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	183	117	$49.20	$24.33
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	45	44	$75.23	$70.74
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	42	41	$983.00	$94.25
99231 Follow-up hospital inpatient care per day, typically 15 minutes	42	22	$95.00	$37.52
99213 Established patient office or other outpatient visit, typically 15 minutes	39	35	$51.09	$48.47
11100 Biopsy of single growth of skin and/or tissue	27	27	$83.60	$46.12
45380 Biopsy of large bowel using an endoscope	26	26	$1412.00	$151.48
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	21	21	$76.29	$68.49
99221 Initial hospital inpatient care per day, typically 30 minutes	20	14	$188.00	$96.81
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	16	16	$121.60	$119.72

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License NC 9900198

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

8911906 (NC)

Commercial Insurance / Payer ID Bcbsnc

11906 (NC)

Hospital & Practice Group Affiliations

Pineville Community Health Center Inc

850 Riverview Ave, Pineville, KY 409771452

Phone: 6063373051251

Appalachian Regional Healthcare Inc

2004 Cumberland Ave, Middlesboro, KY 409651385

Phone: 6062483015

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners

Karen Mcdaniel , ARNP

Nurse Practitioner - Family

NPI 1144278631

Advanced Registered Nurse Practitioner

Dr. Neil Barry , MD

Internal Medicine

NPI 1235125972

Doctor of Medicine (M.D.)

Pamela Cavins , NP-C

Nurse Practitioner - Family

NPI 1780122671

Nurse Practitioner (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active October 20, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location October 20, 2011

Registered at 3004 CUMBERLAND AVE, MIDDLESBORO, KY 409652343 (Tel: 6062484131)

📍

Updated Business Mailing Address October 20, 2011

Registered at 3004 CUMBERLAND AVE, MIDDLESBORO, KY 409652343 (Tel: 6062484131)

👤

Provider Name / Credentials Updated October 20, 2011

Recorded as CHARLES CRUMLEY, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 20, 2011

Surgery (License #9900198 in NC)

🟢

Initial NPI Registration & Enumeration June 03, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1932147519

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 03, 2006

Last Update: October 20, 2011

Sole Proprietor: No

Update or Correct Profile

Mailing Address

3004 Cumberland Ave

Middlesboro, KY 409652343

Phone: 6062484131

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.