DANIEL JAMES GAVIN M.D.
NPI 1083650105
Internal Medicine - Critical Care Medicine in Pikeville, KY

Q: What is Daniel Gavin's NPI number?

The NPI number for Daniel Gavin is 1083650105. It was assigned to this individual provider in the NPPES registry on June 20, 2006.

Q: What is Daniel Gavin's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Q: When was this NPI record last updated?

The NPPES record for Daniel Gavin was last updated on August 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since June 20, 2006PECOS EnrolledAccepts Medicare Assignment

911 BYPASS RD, PIKEVILLE, KY 41501(806) 430-3500 Get Directions Write a Review

NPPES record last updated: August 13, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 13, 2024, Jun 5, 2024 (2 updates tracked since 2024).

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About Daniel James Gavin M.d. NPPES

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

DANIEL JAMES GAVIN M.D. (NPI 1083650105) is an individual critical care medicine provider in Pikeville, Kentucky, licensed in Tennessee (MD37069) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Pikeville Medical Center, and maintains a secondary practice location in Oak Ridge.

NPPES Registry Identity

NPI1083650105

Entity TypeIndividualMale

Primary Taxonomy207RC0200X

Provider Legal NameDANIEL JAMES GAVINCredential: M.D.

Location Address911 BYPASS RDPikeville, KY 41501-1602

Mailing Address730 Frost Bottom RdOliver Springs, TN 37840-6006 · (865) 696-4104

Phone(806) 430-3500

Sole ProprietorNo

Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 1991

Enumeration DateJune 20, 2006

Last NPPES UpdateAugust 13, 20242 updates tracked since enumeration

NPPES CertifiedAugust 13, 2024

✔ NPI 1083650105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RC0200X

Licenses✔ Licensed in TN · MD37069✔ Licensed in KY · C2791

Definition

An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

911 BYPASS RD, Pikeville, KY 41501

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Secondary Practice Location 1

Location 1990 Oak Ridge TpkeOak Ridge, TN 37830-6976 · Phone (865) 835-1000 · Fax (865) 539-8008

Other Identifiers 3

Medicaid3882314TN

OtherP00317078TN · Railroad Medicare

Other4123793TN · Bcbs Of Tennessee

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Daniel James Gavin 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 ID42223810

PECOS Enrollment IDI20240711001498

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.

Medicare Billing Reassignments

Medicare enrollment records show Daniel Gavin reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pikeville Medical Center Inc.

Same address

Multi-Specialty

911 BYPASS RD BLDG A
Pikeville, KY 41501

Reassigned Medicare billing, Kentucky enrollment
579 clinicians in this Medicare group

NPI 1528195864 (606) 430-3500

Southeastern Physician Services PC

138 mi

Hospitalist

990 OAK RIDGE TPKE
Oak Ridge, TN 37830

Reassigned Medicare billing, Tennessee enrollment
1,085 clinicians in this Medicare group

NPI 1083835441 (865) 481-1000

Hospital Medicine Services Of Tennessee PC

171 mi

Hospitalist

600 WILSON CREEK RD
Lawrenceburg, IN 47025

Reassigned Medicare billing, Tennessee enrollment
394 clinicians in this Medicare group

NPI 1528433802 (812) 537-1010

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

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.

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

125 services50 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.

29 services17 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.

25 services18 patients

Insertion of non-tunneled central venous tube for infusion (5 years or older) 36556

This procedure involves placing a thin tube into a large vein, usually in the neck or chest, to administer medication or fluids. It's done under local anesthesia to minimize discomfort. It's a standard, safe procedure for individuals aged 5 and above.

12 services12 patients

Hospital Affiliations CMS Care Compare

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

Pikeville Medical Center

Acute Care Hospitals · Pikeville, KY

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180044

Location911 Bypass RoadPikeville, KY 41501 · Pike County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41501 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

$122.77 typical visit price

range $52.76 – $162.27

Typical copayment $30.69 (range $13.19 – $40.56)

Most-billed visit code 99204

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

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.

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

100%72 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

ABDEL RAHMAN LATAIFEH MBBS

Internal Medicine (Critical Care Medicine)

911 BYPASS RD
PIKEVILLE, KY 41501

Pike County (606) 218-4524

SELINA A. HOLLEY DIETITIAN

Dietitian, Registered

911 BYPASS RD
PIKEVILLE, KY 41501

Pike County (606) 218-3500

YOUSOF E ELGARIED MBBS

Internal Medicine (Pulmonary Disease)

911 BYPASS RD
PIKEVILLE, KY 41501

Pike County (606) 218-3500

LESLIE A. ARNETT APRN

Nurse Practitioner

911 BYPASS RD, CLINIC 2
PIKEVILLE, KY 41501

Pike County (606) 218-6402

KRISTA CORA DOTSON

Registered Nurse

911 BYPASS RD
PIKEVILLE, KY 41501

Pike County (606) 430-2201

AARON RATLIFF PHARMD

Pharmacist

911 BYPASS RD
PIKEVILLE, KY 41501

Pike County (606) 218-3576

MICHAEL D LUDLOW APRN

Nurse Practitioner

911 BYPASS RD
PIKEVILLE, KY 41501

Pike County (606) 218-3500

PIKEVILLE MEDICAL CENTER, INC.

Nurse Anesthetist, Certified Registered

911 BYPASS RD
PIKEVILLE, KY 41501

Pike County (606) 218-3500

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 Daniel Gavin's NPI number?

The NPI number for Daniel Gavin is 1083650105. It was assigned to this individual provider in the NPPES registry on June 20, 2006.

Where is Daniel Gavin located?

Daniel Gavin practices at 911 Bypass Rd, Pikeville, KY 41501. The listed phone number is (806) 430-3500.

What is Daniel Gavin's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Is Daniel Gavin enrolled in Medicare?

Yes. Daniel Gavin 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.

Which organizations bill Medicare for Daniel Gavin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Daniel Gavin reassigns Medicare benefits to 3 organizations: Pikeville Medical Center Inc. (Pikeville, KY), Southeastern Physician Services PC (Oak Ridge, TN) and Hospital Medicine Services Of Tennessee PC (Lawrenceburg, IN). Each 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 Daniel Gavin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Daniel Gavin accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee and CareSource list Daniel Gavin 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 Daniel Gavin affiliated with any hospitals?

According to CMS data, Daniel Gavin is affiliated with Pikeville Medical Center.

When was this NPI record last updated?

The NPPES record for Daniel Gavin was last updated on August 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.