TONYA COBURN (P.A.-C) – Medical Physician Assistant, NPI 1639170590

TONYA COBURN (P.A.-C) is a healthcare provider. based in Versailles, Kentucky. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P.A.-C. They hold a License No. PA452 (KY). The NPI Number for TONYA COBURN (P.A.-C) is 1639170590

Main info

Female
28 Years Of Experience
Accepts Medicare Assignment
Name
TONYA COBURN (P.A.-C)
NPI
1639170590
Phone
(859) 879-0111
Address
460 WILSON AVE
Enumeration Date
2 August 2005
Last Update Date
9 June 2022

Doctor Profile

Medical School Name
UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
Secondary Phone
-
Graduation Year
1998 (28 years ago)
PAC ID
8325032154
Group Practice PAC ID
2668576927
Professional Enrollment ID
I20040413001525
Address ID
KY403831947VE460XXFLXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,728 PHYSICIAN ASSISTANT in KY

Provider Addresses for TONYA COBURN (P.A.-C)

  • 460 WILSON AVE

    VERSAILLES, KY 403831947

    Phone: (859) 879-0111

    Fax: (859) 879-0363

    Type: Location

  • Bluegrass Community Hospital, 360, Amsden Avenue, Versailles, Woodford County, Kentucky, 40383, United States

    SUITE 504

    VERSAILLES, KY 403831851

    Phone: (859) 879-0111

    Fax: (859) 879-0363

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $92.

Total Amount is formed as General ($92) + Research ($0) + Ownership ($0) = $92.

Last reported payment date: 2024-10-18 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($36).

Total Amount

$92

General + Research + Ownership

Payments

5

Total payment records

General Amount

$92

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-04-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040413001525IPhysician AssistantKYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes3027$0
View full utilization report →

Insurance plans in this area (ZIP 40383)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2668576927View full group profile
NameSpecialtyState
Physician AssistantKY
Nurse PractitionerKY
Nurse PractitionerKY
Nurse PractitionerKY
-KY
Physician AssistantKY
Physician AssistantKY
Physician AssistantKY
Family Practice, Hospice/Palliative Care, HospitalistKY

Reviews

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Frequently asked questions

What is the registry number for TONYA COBURN (P.A.-C)?
The registry entry for TONYA COBURN (P.A.-C) shows NPI 1639170590.
Quick check: is TONYA COBURN (P.A.-C) active?
Public NPPES data shows TONYA COBURN (P.A.-C) with an active NPI status right now.
What does the directory say TONYA COBURN (P.A.-C) does?
Insurance directories may phrase it differently, but here TONYA COBURN (P.A.-C) maps to Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
Can patients visit TONYA COBURN (P.A.-C) in Versailles, Kentucky?
For routing, start with Versailles, Kentucky for TONYA COBURN (P.A.-C), then verify phone and hours locally.
Can I export TONYA COBURN (P.A.-C)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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