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JAMES G. GAAL DO
NPI 1023070703
Internal Medicine in Ripley, WV

Active since April 06, 2006PECOS EnrolledAccepts Medicare Assignment
94.1/100
CMS Quality Rating
158 PINNELL ST, RIPLEY, WV 25271(304) 372-4402(304) 372-9221 Get Directions Write a Review

NPPES record last updated: April 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 21, 2022, Jan 10, 2021, May 15, 2020 (3 updates tracked since 2020).

About James G. Gaal Do NPPES

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

JAMES G. GAAL DO (NPI 1023070703) is an individual internal medicine provider in Ripley, West Virginia, licensed in West Virginia (1161) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Thomas Memorial Hospital, and is a graduate of West Virginia School Of Osteopathic Medicine (1987).

NPPES Registry Identity

NPI1023070703
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameJAMES G. GAALCredential: DO
Location Address158 PINNELL STRipley, WV 25271-9101
Mailing Address158 Pinnell StRipley, WV 25271-9101 · (304) 372-4402 · Fax (304) 372-9221
Phone(304) 372-4402
Fax(304) 372-9221
Sole ProprietorYes
Medical School CMSWest Virginia School Of Osteopathic MedicineGraduated 1987
Enumeration DateApril 6, 2006
Last NPPES UpdateApril 21, 20223 updates tracked since enumeration
NPPES CertifiedApril 21, 2022
✔ NPI 1023070703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in WV · 1161
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
158 PINNELL ST, Ripley, WV 25271
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Highmark Blue Cross Blue Shield West Virginia.Insurance ›

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

James G. Gaal Do 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 ID9830009968
PECOS Enrollment IDI20080114000537
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 8

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
396 services82 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
155 services61 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
50 services22 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes 99307
A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.
48 services13 patients
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.
46 services25 patients
Transitional care management services for problem of high complexity 99496
Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.
20 services17 patients

Hospital Affiliations CMS Care Compare 2

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

Thomas Memorial Hospital

Acute Care Hospitals · South Charleston, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510029
Location4605 Maccorkle Avenue SWSouth Charleston, WV 25309 · Kanawha County
Emergency services Birthing friendly

Jackson General Hospital

Critical Access Hospitals · Ripley, WV
OwnershipVoluntary non-profit - Private
CMS Certification Number511320
Location122 Pinnell StRipley, WV 25271 · Jackson County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25271 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
$124.46 typical visit price
range $53.20 – $164.59
Typical copayment $31.11 (range $13.30 – $41.14)
Most-billed visit code 99204
Established Patient
$94.81 typical visit price
range $16.47 – $133.29
Typical copayment $23.70 (range $4.11 – $33.32)
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.

94.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.46
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 16

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
7 suppliers28 claims107 services$5.91 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers19 claims34 services$0.98 avg. paid by Medicare
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357
DME-Orthotic Devices · category DF000N
1 supplier18 claims18 services$7.82 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress E0261
DME-Hospital Beds · category DB000N
1 supplier20 claims20 services$55.96 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 suppliers28 claims28 services$19.08 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
2 suppliers13 claims13 services$909.12 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 2

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

JAMES GAAL DO
Internal Medicine
158 PINNELL ST
RIPLEY, WV 25271
Jackson County (304) 372-4402
AMY DELONG APRN
Nurse Practitioner
158 PINNELL ST
RIPLEY, WV 25271
Jackson County (304) 372-4402

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 James Gaal's NPI number?

The NPI number for James Gaal is 1023070703. It was assigned to this individual provider in the NPPES registry on April 6, 2006.

Where is James Gaal located?

James Gaal practices at 158 Pinnell St, Ripley, WV 25271. The listed phone number is (304) 372-4402.

What is James Gaal's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is James Gaal enrolled in Medicare?

Yes. James Gaal 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.

What insurance does James Gaal accept?

Health plans from Highmark Blue Cross Blue Shield West Virginia list James Gaal as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is James Gaal affiliated with any hospitals?

According to CMS data, James Gaal is affiliated with Thomas Memorial Hospital and Jackson General Hospital.

When was this NPI record last updated?

The NPPES record for James Gaal was last updated on April 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.