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MICHAEL G GILHOOLEY MD
NPI 1093751034
Internal Medicine in Scranton, PA

Active since June 20, 2006PECOS EnrolledAccepts Medicare Assignment
18.99/100
CMS Quality Rating
821 OAK ST, SCRANTON, PA 18508(570) 703-0539 Get Directions Write a Review

NPPES record last updated: April 3, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 3, 2025, Jan 15, 2019 (2 updates tracked since 2019).

About Michael G Gilhooley Md NPPES

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

MICHAEL G GILHOOLEY MD (NPI 1093751034) is an individual internal medicine provider in Scranton, Pennsylvania, licensed in Pennsylvania (MD053831L) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Geisinger-community Medical Center, and maintains a secondary practice location in Scranton.

NPPES Registry Identity

NPI1093751034
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameMICHAEL G GILHOOLEYCredential: MD
Location Address821 OAK STScranton, PA 18508-1260
Mailing Address100 N Academy Ave # Mc4903Danville, PA 17822-9800 · (570) 271-6144 · Fax (570) 271-6578
Phone(570) 703-0539
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateJune 20, 2006
Last NPPES UpdateApril 3, 20252 updates tracked since enumeration
NPPES CertifiedApril 3, 2025
✔ NPI 1093751034 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in PA · MD053831L
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.
821 OAK ST, Scranton, PA 18508
Open in Google Maps ↗

Secondary Practice Location 1

Location 11789 N Keyser AveScranton, PA 18508-1250 · Phone (570) 969-1904 · Fax (570) 207-5314

Other Identifiers 1

Medicaid0015152200002PA

Accepted Insurance

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

Michael G Gilhooley Md 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 ID2365487535
PECOS Enrollment IDI20050628000570
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 6

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.
483 services256 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.
481 services214 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
167 services58 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
21 services21 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
18 services18 patients
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
16 services16 patients

Hospital Affiliations CMS Care Compare 5

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

Geisinger-Community Medical Center

Acute Care Hospitals · Scranton, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390001
Location1822 Mulberry StreetScranton, PA 18510 · Lackawanna County
Emergency services Birthing friendly

Wayne Memorial Hospital

Acute Care Hospitals · Honesdale, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390125
Location601 Park StreetHonesdale, PA 18431 · Wayne County
Emergency services Birthing friendly

Wilkes-Barre General Hospital

Acute Care Hospitals · Wilkes-Barre, PA
1/5 CMS rating
OwnershipProprietary
CMS Certification Number390137
Location575 North River StreetWilkes-Barre, PA 18764 · Luzerne County
Emergency services

Regional Hospital Of Scranton

Acute Care Hospitals · Scranton, PA
2/5 CMS rating
OwnershipProprietary
CMS Certification Number390237
Location746 Jefferson AvenueScranton, PA 18501 · Lackawanna County
Emergency services Birthing friendly

Geisinger Wyoming Valley Medical Center

Acute Care Hospitals · Wilkes Barre, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390270
Location1000 East Mountain BoulevardWilkes Barre, PA 18711 · Luzerne County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18508 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

18.99/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0
Cost63.33

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
9 suppliers29 claims63 services$5.65 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
5 suppliers11 claims11 services$0.93 avg. paid by Medicare
Urinary catheter anchoring device, leg strap, each A4334
DME-Orthotic Devices · category DF000N
2 suppliers12 claims12 services$4.73 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
2 suppliers17 claims20 services$8.83 avg. paid by Medicare
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4036
Other-Enteral and Parenteral · category OB006N
1 supplier11 claims341 services$3.25 avg. paid by Medicare
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152
Other-Enteral and Parenteral · category OB006N
1 supplier11 claims5,172 services$0.25 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 5

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

AMBER SHOLTES PA-C
Physician Assistant
821 OAK ST
SCRANTON, PA 18508
Lackawanna County (570) 703-0539
CROSSGATE SLEEP CENTER, LLC
Clinic/Center (Sleep Disorder Diagnostic)
821 OAK ST
SCRANTON, PA 18508
Lackawanna County (570) 342-0250
GEISINGER CLINIC
Clinic/Center
821 OAK ST
SCRANTON, PA 18508
Lackawanna County (570) 703-0539
MARISA SIEKIERKA PA-C
Physician Assistant (Medical)
821 OAK ST
SCRANTON, PA 18508
Lackawanna County (570) 703-0539
DR. SCOTT J. PETTINATO D.M.D.
Dentist (General Practice)
821 OAK ST, SUITE #2
SCRANTON, PA 18508
Lackawanna County (570) 558-9900

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 Michael Gilhooley's NPI number?

The NPI number for Michael Gilhooley is 1093751034. It was assigned to this individual provider in the NPPES registry on June 20, 2006.

Where is Michael Gilhooley located?

Michael Gilhooley practices at 821 Oak St, Scranton, PA 18508. The listed phone number is (570) 703-0539.

What is Michael Gilhooley's specialty?

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

Is Michael Gilhooley enrolled in Medicare?

Yes. Michael Gilhooley 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 Michael Gilhooley accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Michael Gilhooley 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 Michael Gilhooley affiliated with any hospitals?

According to CMS data, Michael Gilhooley is affiliated with Geisinger-Community Medical Center, Wayne Memorial Hospital, Wilkes-Barre General Hospital, Regional Hospital Of Scranton and Geisinger Wyoming Valley Medical Center.

When was this NPI record last updated?

The NPPES record for Michael Gilhooley was last updated on April 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.