MARK A GAPINSKI MD
NPI 1073655601
Obstetrics & Gynecology in Winfield, IL
NPI Status: Active since February 12, 2007
Contact Information
25 N WINFIELD RD
SUITE 511
WINFIELD, IL
ZIP 60190
Phone: (630) 462-4963
Fax: (630) 462-0635
- Individual
- Male
- Obstetrics & Gynecology
- PECOS Enrolled
- Opted-Out Medicare
- CLIA Number: 14D1068295
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-31-2027
About MARK GAPINSKI
This page provides the complete NPI Profile along with additional information for Mark Gapinski, a women's health care provider established in Winfield, Illinois with a medical specialization in Obstetrics & Gynecology. The healthcare provider is registered in the NPI registry with number 1073655601 assigned on February 2007. The practitioner's primary taxonomy code is 207V00000X. The provider is registered as an individual and his NPI record was last updated 18 years ago.
- NPI
- 1073655601
- Provider Name
- MARK A GAPINSKI MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 25 N WINFIELD RD SUITE 511 WINFIELD, IL 60190
- Location Phone
- (630) 462-4963
- Location Fax
- (630) 462-0635
- Mailing Address
- 567 HILLSIDE AVE GLEN ELLYN, IL 60137
- Mailing Phone
- (630) 462-4963
- Mailing Fax
- (630) 462-0635
- Is Sole Proprietor?
- No
- Enumeration Date
- 02-12-2007
- Last Update Date
- 02-07-2008
- Code Navigator
Women's health care providers like Mark Gapinski treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Mark Gapinski opted out of Medicare effective on 06-10-2016 until 06-10-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
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
Obstetrics & Gynecology
- Taxonomy Code
- 207V00000X
- Type
- Allopathic & Osteopathic Physicians
- License State
- IL
- Taxonomy Description
- An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
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.
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 |
|---|---|---|---|
| 02233162 | OTHER (01) | IL | BCBS OF IL |
| K36510 | MEDICARE PIN (08) | ||
| H65668 | MEDICARE UPIN (02) | IL | |
| K36677 | MEDICARE PIN (08) |
Medicare Participation & PECOS Enrollment Status
Mark Gapinski 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
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 06-10-2016
Opt-Out End Date: 06-10-2026
Eligible to Order and Refer? 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
Physician 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 60190 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $137.43
- Minimum New Patient Price $59.81
- Maximum New Patient Price $181.38
- Average New Patient Copayment $34.35
- Minimum New Patient Copayment $14.95
- Maximum New Patient Copayment $45.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $74.38
- Minimum Established Patient Price $19.15
- Maximum Established Patient Price $147.12
- Average Established Patient Copayment $18.59
- Minimum Established Patient Copayment $4.78
- Maximum Established Patient Copayment $36.78
* 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.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D1068295
- Facility Type
- Physician Office
- Certificate Effective Date
- November 01, 2025
- Certificate Expiration Date
- October 31, 2027
- Laboratory Director
- MARK A. GAPINSKI
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Mark Gapinski in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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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 1073655601, we treat the final digit (1) 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 49. The final step is to find the difference between that total and the next multiple of ten (50 - 49 = 1).
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 49 is 50. 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.
WINFIELD, IL 60190
WINFIELD, IL 60190
WINFIELD, IL 60190
WINFIELD, IL 60190
WINFIELD, IL 60190
WINFIELD, IL 60190
WINFIELD, IL 60190
WINFIELD, IL 60190
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1073655601, enumerated as an "individual" on February 12, 2007.
The provider is located at 25 N WINFIELD RD SUITE 511 WINFIELD, IL 60190 and the phone number is (630) 462-4963.
Obstetrics & Gynecology with taxonomy code 207V00000X.
The provider might be accepting Accepts: Blue Cross Blue Shield, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
