JOHN A. GILLESPIE M.D.
NPI 1013998202
Family Medicine in Berlin, MD

Active since November 07, 2005PECOS EnrolledAccepts Medicare Assignment
77.45/100
CMS Quality Rating
9733 HEALTHWAY DR, BERLIN, MD 21811(410) 641-9109(410) 629-1203 Get Directions Write a Review

NPPES record last updated: April 18, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About John A. Gillespie M.d. NPPES

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

JOHN A. GILLESPIE M.D. (NPI 1013998202) is an individual family medicine provider in Berlin, Maryland, licensed in Maryland (D0063904) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Tidalhealth Peninsula Regional, Inc, and is a graduate of University Of Pittsburgh School Of Medicine (1996).

NPPES Registry Identity

NPI1013998202
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJOHN A. GILLESPIECredential: M.D.
Location Address9733 HEALTHWAY DRBerlin, MD 21811-1155
Mailing Address10026 Old Ocean City Blvd, Building OneBerlin, MD 21811-1288 · (410) 641-9109 · Fax (410) 629-1203
Fax(410) 629-1203
Sole ProprietorNo
Medical School CMSUniversity Of Pittsburgh School Of MedicineGraduated 1996
Enumeration DateNovember 7, 2005
Last NPPES UpdateApril 18, 2012
NPI 1013998202 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in MD · D0063904
Definition

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.

Also ListedHospitalistTaxonomy 208M00000X · License D0063904 (MD)
9733 HEALTHWAY DR, Berlin, MD 21811

Other Identifiers 3

Medicare PINKP95N396MD
Medicaid409649500MD
Medicaid1000038891DE

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

John A. Gillespie M.d. 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 ID941249650
PECOS Enrollment IDI20060303000669
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.

Areas of Expertise CMS Part B claims 7

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
339 services195 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
120 services116 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
101 services95 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
82 services63 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
63 services63 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
23 services23 patients

Hospital Affiliations CMS Care Compare 2

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

Tidalhealth Peninsula Regional, Inc

Acute Care Hospitals · Salisbury, MD
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number210019
Location100 East Carroll AvenueSalisbury, MD 21801 · Wicomico County
Emergency services Birthing friendly

Atlantic General Hospital

Acute Care Hospitals · Berlin, MD
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number210061
Location9733 Healthway DriveBerlin, MD 21811 · Worcester County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21811 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
$89.75 typical visit price
range $57.99 – $175.57
Typical copayment $22.43 (range $14.49 – $43.89)
Most-billed visit code 99203
Established Patient
$102.11 typical visit price
range $18.66 – $143.02
Typical copayment $25.52 (range $4.66 – $35.75)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

77.45/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality77.52
Promoting Interoperability87
Improvement Activities40
Cost58.13

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
2 suppliers13 claims13 services$40.42 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers110 claims115 services$16.63 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers112 claims117 services$86.85 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Pharmacy
9733 HEALTHWAY DR
BERLIN, MD 21811
Internal Medicine (Pulmonary Disease)
9733 HEALTHWAY DR
BERLIN, MD 21811
General Acute Care Hospital
9733 HEALTHWAY DR
BERLIN, MD 21811
Internal Medicine
9733 HEALTHWAY DR
BERLIN, MD 21811
Pharmacist
9733 HEALTHWAY DR
BERLIN, MD 21811
Nurse Practitioner (Family)
9733 HEALTHWAY DR
BERLIN, MD 21811
Speech-Language Pathologist
9733 HEALTHWAY DR
BERLIN, MD 21811
Psychiatry & Neurology (Neurology)
9733 HEALTHWAY DR
BERLIN, MD 21811

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Gillespie's NPI number?

The NPI number for John Gillespie is 1013998202. It was assigned to this individual provider in the NPPES registry on November 7, 2005.

Where is John Gillespie located?

John Gillespie practices at 9733 Healthway Dr, Berlin, MD 21811. The listed phone number is (410) 641-9109.

What is John Gillespie's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is John Gillespie enrolled in Medicare?

Yes. John Gillespie is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is John Gillespie affiliated with any hospitals?

According to CMS data, John Gillespie is affiliated with Tidalhealth Peninsula Regional, Inc and Atlantic General Hospital.

When was this NPI record last updated?

The NPPES record for John Gillespie was last updated on April 18, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.