GILLUM FACIAL PLASTIC SURGERY, PC
NPI 1063563617
Specialist in Marion, IN
About Gillum Facial Plastic Surgery, Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GILLUM FACIAL PLASTIC SURGERY, PC (NPI 1063563617) is a healthcare organization registered as a specialist in Marion, Indiana and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through May 20, 2028 and lists Timothy G Gillum, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Gillum Facial Plastic Surgery, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by October 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Gillum Facial Plastic Surgery, PC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 15D2148851
Gillum Facial Plastic Surgery-D/B/A Gillum Sinus & Allergy · Marion, INFrequently 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 Gillum Facial Plastic Surgery, PC's NPI number?
The NPI number for Gillum Facial Plastic Surgery, PC is 1063563617. It was assigned to this organization in the NPPES registry on January 12, 2007.
Where is Gillum Facial Plastic Surgery, PC located?
Gillum Facial Plastic Surgery, PC is located at 330 N Wabash Ave Ste 210, Marion, IN 46952. The listed phone number is (765) 651-4278.
What is Gillum Facial Plastic Surgery, PC's specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is Gillum Facial Plastic Surgery, PC enrolled in Medicare?
Yes. Gillum Facial Plastic Surgery, PC is registered in the Medicare PECOS enrollment system.
When is Gillum Facial Plastic Surgery, PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Indiana, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Gillum Facial Plastic Surgery, PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Gillum Facial Plastic Surgery, PC, in Nurse Practitioner and Otolaryngology. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Gillum Facial Plastic Surgery, PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 15D2148851) is associated with this NPI, valid through May 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Gillum Facial Plastic Surgery, PC accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Gillum Facial Plastic Surgery, PC 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.
When was this NPI record last updated?
The NPPES record for Gillum Facial Plastic Surgery, PC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Gillum Facial Plastic Surgery, Pc · NPI 1063563617
Specialist organization in Marion, Indiana. Organization record, active in the CMS NPPES registry since January 12, 2007.
## Identity
- **NPI:** 1063563617 (Entity type: Organization)
- **Enumerated:** January 12, 2007
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Organization subpart:** No
- **Authorized official:** Timothy Gillum, OWNER
## Practice location
- **Address:** 330 N WABASH AVE, STE 210, Marion, IN 46952-2600
- **Phone:** (765) 651-4278 · **Fax:** (765) 664-6445
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (Non-DME Part B, Indiana, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (1), Otolaryngology (1); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 22, 2020
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1063563617) · Data from the CMS NPPES public registry.