GARY A CLAY MD
NPI 1013980325
Family Medicine in Bellows Falls, VT
NPI Status: Active since February 08, 2006
Contact Information
1 HOSPITAL CT
BELLOWS FALLS, VT
ZIP 05101
Phone: (802) 463-9000
- Individual
- Male
- Family Medicine
- Accepts Insurance
- PECOS Enrolled
About GARY CLAY
This page provides the complete NPI Profile along with additional information for Gary Clay, a primary care provider established in Bellows Falls, Vermont with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1013980325 assigned on February 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 0420007548 (VT). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1013980325
- Provider Name
- GARY A CLAY MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1 HOSPITAL CT BELLOWS FALLS, VT 05101
- Location Phone
- (802) 463-9000
- Mailing Address
- PO BOX 710 SPRINGFIELD, VT 05156
- Mailing Phone
- (802) 463-9000
- Is Sole Proprietor?
- No
- Enumeration Date
- 02-08-2006
- Last Update Date
- 09-27-2011
- Code Navigator
A primary care provider (PCP) like Gary Clay sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 0420007548
- License State
- VT
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Preferred Blue PPO 6000/20%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 7000/50%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 7500/30%/10000 Value - PPO
- Anthem Bronze Preferred Blue PPO 8500/50%/9200 - PPO
- Anthem Gold Preferred Blue PPO 1000/20%/7500 - PPO
- Anthem Gold Preferred Blue PPO 2000/0%/6500 RxD - PPO
- Anthem Gold Preferred Blue PPO 2000/10%/4600 w/HSA - PPO
- Anthem Gold Preferred Blue PPO 2000/10%/7500 - PPO
- Anthem Gold Preferred Blue PPO 2000/20%/4600 w/HSA - PPO
- Anthem Gold Preferred Blue PPO 3000/0%/7500 RxD - PPO
- Anthem Gold Preferred Blue PPO 500/30%/9000 - PPO
- Anthem Platinum Preferred Blue PPO 250/10%/3500 - PPO
- Anthem Silver Preferred Blue PPO 2500/30%/10000 Value - PPO
- Anthem Silver Preferred Blue PPO 3000/30%/9000 Value - PPO
- Anthem Silver Preferred Blue PPO 3500/20%/10000 - PPO
- Anthem Silver Preferred Blue PPO 3500/20%/7250 w/HSA - PPO
- Anthem Silver Preferred Blue PPO 4000/0%/9000 - PPO
- Anthem Silver Preferred Blue PPO 4000/0%/9000 RxD - PPO
- Anthem Silver Preferred Blue PPO 4000/10%/7250 w/HSA - PPO
- Anthem Silver Preferred Blue PPO 4000/20%/8500 - PPO
- Anthem Bronze Pathway X Enhanced 6000/35% HSA - HMO
- Anthem Bronze Pathway X Enhanced 7000/0% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway X Enhanced 7500/50% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Catastrophic Pathway X Enhanced - HMO
- Anthem Gold Pathway X Enhanced 1200/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Gold Pathway X Enhanced 2000/25% ($0 Virtual PCP + $0 Select Drug) Standard - HMO
- Anthem Gold Pathway X Enhanced 700/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Bronze Pathway X Enhanced 6000/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Silver Pathway X Enhanced 4000/0% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway X Enhanced 4500/20% HSA - HMO
- Anthem Silver Pathway X Enhanced 5500/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway X Enhanced 6000/40% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Bronze Access Blue New England HMO 6000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7500/30%/10000 Value - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
- Anthem Bronze Pathway X HMO 6000/20%/8000 w/HSA - HMO
- Anthem Bronze Pathway X HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Pathway X HMO 7500/30%/10000 Value - HMO
- Anthem Bronze Pathway X HMO 8500/50%/9200 - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0009083 | MEDICAID (05) | VT | |
| D77082 | MEDICARE UPIN (02) | ||
| VT9083 | MEDICARE ID-TYPE UNSPECIFIED (04) | VT |
Medicare Participation & PECOS Enrollment Status
Gary Clay is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
8 DME suppliers used 77 Medicare Claims 201 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Lancets, per box of 100 (HCPCS:A4259)
7 DME suppliers used 30 Medicare Claims 42 Services Paid
DME-Other DME (DE001N)
Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)
2 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Other DME (DE000N)
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable (HCPCS:A7003)
3 DME suppliers used 21 Medicare Claims 37 Services Paid
DME-Other DME (DE000N)
Filter, disposable, used with aerosol compressor or ultrasonic generator (HCPCS:A7013)
1 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Other DME (DE001N)
Full face mask used with positive airway pressure device, each (HCPCS:A7030)
5 DME suppliers used 18 Medicare Claims 18 Services Paid
DME-Other DME (DE001N)
Face mask interface, replacement for full face mask, each (HCPCS:A7031)
5 DME suppliers used 16 Medicare Claims 42 Services Paid
DME-Other DME (DE001N)
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)
2 DME suppliers used 11 Medicare Claims 11 Services Paid
DME-Other DME (DE001N)
Headgear used with positive airway pressure device (HCPCS:A7035)
5 DME suppliers used 18 Medicare Claims 18 Services Paid
DME-Other DME (DE001N)
Tubing used with positive airway pressure device (HCPCS:A7037)
3 DME suppliers used 14 Medicare Claims 14 Services Paid
DME-Other DME (DE001N)
Filter, disposable, used with positive airway pressure device (HCPCS:A7038)
6 DME suppliers used 29 Medicare Claims 160 Services Paid
DME-Other DME (DE001N)
Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)
5 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Hospital Beds (DB000N)
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)
1 DME suppliers used 14 Medicare Claims 14 Services Paid
DME-Other DME (DE000N)
Nebulizer, with compressor (HCPCS:E0570)
2 DME suppliers used 24 Medicare Claims 24 Services Paid
DME-Other DME (DE001N)
Continuous positive airway pressure (cpap) device (HCPCS:E0601)
3 DME suppliers used 25 Medicare Claims 25 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
3 DME suppliers used 31 Medicare Claims 31 Services Paid
DME-Oxygen and Supplies (DC002N)
Portable oxygen concentrator, rental (HCPCS:E1392)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Other DME (DE017N)
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)
4 DME suppliers used 82 Medicare Claims 82 Services Paid
DME-Other DME (DE000N)
Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)
7 DME suppliers used 44 Medicare Claims 44 Services Paid
Drugs Administered Through DME
DME-Drugs Administered Through DME (DG006N)
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg (HCPCS:J7613)
6 DME suppliers used 50 Medicare Claims 8302 Services Paid
DME-Drugs Administered Through DME (DG006N)
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)
3 DME suppliers used 12 Medicare Claims 3177 Services Paid
DME-Drugs Administered Through DME (DG000N)
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg (HCPCS:J7626)
2 DME suppliers used 14 Medicare Claims 960 Services Paid
DME-Drugs Administered Through DME (DG006N)
Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram (HCPCS:J7677)
1 DME suppliers used 11 Medicare Claims 57750 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Automated urinalysis test
Hemoglobin a1c level
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
This service was performed 14 times for 12 patientsHemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
This service was performed 63 times for 40 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 05101 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $85.89
- Minimum New Patient Price $55.8
- Maximum New Patient Price $168.48
- Average New Patient Copayment $21.47
- Minimum New Patient Copayment $13.95
- Maximum New Patient Copayment $42.12
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $98.4
- Minimum Established Patient Price $18.08
- Maximum Established Patient Price $137.84
- Average Established Patient Copayment $24.6
- Minimum Established Patient Copayment $4.52
- Maximum Established Patient Copayment $34.46
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1013980325, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 55 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
BELLOWS FALLS, VT 05101
BELLOWS FALLS, VT 05101
BELLOWS FALLS, VT 05101
BELLOWS FALLS, VT 05101
BELLOWS FALLS, VT 05101
BELLOWS FALLS, VT 05101
BELLOWS FALLS, VT 05101
BELLOWS FALLS, VT 05101
BELLOWS FALLS, VT 05101
BELLOWS FALLS, VT 05101
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1013980325, enumerated as an "individual" on February 08, 2006.
The provider is located at 1 HOSPITAL CT BELLOWS FALLS, VT 05101 and the phone number is (802) 463-9000.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Sheld, Anthem Blue. Please consult your insurance carrier or call the provider to verify.
