JOSEPH J GAINES JR. MD
NPI 1003882036
Pathology - Anatomic Pathology & Clinical Pathology in Athens, GA

Q: What is Joseph Gaines's NPI number?

The NPI number for Joseph Gaines is 1003882036. It was assigned to this individual provider in the NPPES registry on February 28, 2006.

Q: What is Joseph Gaines's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Q: When was this NPI record last updated?

The NPPES record for Joseph Gaines was last updated on March 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.

Active since February 28, 2006PECOS EnrolledAccepts Medicare Assignment

1230 BAXTER ST, ATHENS, GA 30606(706) 389-2425(706) 389-2426 Get Directions Write a Review

NPPES record last updated: March 4, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Joseph J Gaines Jr. Md NPPES

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

JOSEPH J GAINES JR. MD (NPI 1003882036) is an individual anatomic pathology & clinical pathology provider in Athens, Georgia, licensed in Georgia (028550) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with St Mary's Hospital, and is a graduate of Medical College Of Georgia School Of Medicine (1984).

NPPES Registry Identity

NPI1003882036

Entity TypeIndividualMale

Primary Taxonomy207ZP0102X

Provider Legal NameJOSEPH J GAINES JR.Credential: MD

Location Address1230 BAXTER STAthens, GA 30606

Mailing AddressPo Box 491270Lawrenceville, GA 30049 · (770) 237-4500 · Fax (770) 237-4539

Phone(706) 389-2425

Fax(706) 389-2426

Sole ProprietorNo

Medical School CMSMedical College Of Georgia School Of MedicineGraduated 1984

Enumeration DateFebruary 28, 2006

Last NPPES UpdateMarch 4, 2026

NPPES CertifiedMarch 4, 2026

✔ NPI 1003882036 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians

Taxonomy Code207ZP0102X

License✔ Licensed in GA · 028550

Definition

A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.

1230 BAXTER ST, Athens, GA 30606

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Other Identifiers 2

Medicaid00382434BGA

Other220019464GA · Railroad Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Joseph J Gaines Jr. 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 ID648446310

PECOS Enrollment IDI20111229000636

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.

Medicare Billing Reassignments

Medicare enrollment records show Joseph Gaines reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pathology And Laboratory Consultants Of Athens LLC

Same address

Anatomic Pathology & Clinical Pathology

1230 BAXTER ST
Athens, GA 30606

Reassigned Medicare billing, Georgia enrollment
2 clinicians in this Medicare group

NPI 1861460248 (706) 389-2425

St. Mary's Medical Group, Inc.

Same address

Internal Medicine

1230 BAXTER ST
Athens, GA 30606

Reassigned Medicare billing, Georgia enrollment
114 clinicians in this Medicare group

NPI 1235561820 (706) 389-3880

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 11

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.

Pathology examination of tissue using a microscope, intermediate complexity 88305

A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.

1,083 services775 patients

Preparation of tissue for examination by removing any calcium present 88311

This procedure involves treating tissue samples to remove any calcium, which can interfere with the examination. The tissue is soaked in a special solution that safely dissolves the calcium, leaving the tissue intact for accurate analysis. This helps in making precise diagnoses.

278 services267 patients

Special stained specimen slides to examine tissue, initial procedure 88342

This procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.

225 services185 patients

Pathology examination of tissue using a microscope, moderately high complexity 88307

A pathology examination of tissue with moderate complexity involves a detailed study of a small tissue sample from your body. Using a microscope, experts analyze the tissue's structure and cells to identify any abnormalities. This helps in diagnosing various health conditions accurately.

173 services93 patients

Special stained specimen slides to examine tissue, each additional procedure 88341

Special stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.

155 services50 patients

Pathology examination of tissue using a microscope, moderately low complexity 88304

A pathology examination of tissue, moderately low complexity, involves studying a small sample of your body tissue under a microscope. It helps to identify any abnormal cells or diseases. It's a routine procedure, not complex, and provides crucial insights for your diagnosis.

95 services92 patients

Hospital Affiliations CMS Care Compare 3

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

St Mary's Hospital

Acute Care Hospitals · Athens, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110006

Location1230 Baxter StreetAthens, GA 30606 · Clarke County

Emergency services Birthing friendly

Ty Cobb Regional Medical Center, LLC

Acute Care Hospitals · Lavonia, GA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110027

Location367 Clear Creek ParkwayLavonia, GA 30553 · Franklin County

Emergency services Birthing friendly

St. Mary's Good Samaritan Hospital

Critical Access Hospitals · Greensboro, GA

4/5 CMS rating

OwnershipProprietary

CMS Certification Number111329

Location5401 Lake Oconee ParkwayGreensboro, GA 30642 · Greene County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30606 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

$124.10 typical visit price

range $53.31 – $164.04

Typical copayment $31.02 (range $13.32 – $41.01)

Most-billed visit code 99204

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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.

Other Providers at the Same Location NPPES 20

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

LINDA RITTER MD

Anesthesiology