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DR. MICHAEL N GAUTHIER MD
NPI 1154384485
Family Medicine in York, ME

Active since April 08, 2006PECOS EnrolledAccepts Medicare Assignment
98.06/100
CMS Quality Rating
127 LONG SANDS RD, SUITE 11, YORK, ME 03909(207) 363-8430(207) 351-3006 Get Directions Write a Review

NPPES record last updated: April 12, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Michael N Gauthier Md NPPES

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

DR. MICHAEL N GAUTHIER MD (NPI 1154384485) is an individual family medicine provider in York, Maine, licensed in Maine (ME014829) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with York Hospital, and is a graduate of University Of Massachusetts Medical School (1991).

NPPES Registry Identity

NPI1154384485
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. MICHAEL N GAUTHIERCredential: MD
Location Address127 LONG SANDS RD, SUITE 11York, ME 03909-1159
Mailing Address127 Long Sands Rd, Suite 11York, ME 03909-1159 · (207) 363-8430 · Fax (207) 351-3006
Phone(207) 363-8430
Fax(207) 351-3006
Sole ProprietorNo
Medical School CMSUniversity Of Massachusetts Medical SchoolGraduated 1991
Enumeration DateApril 8, 2006
Last NPPES UpdateApril 12, 2011
✔ NPI 1154384485 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in ME · ME014829
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
127 LONG SANDS RD, York, ME 03909
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Other Identifiers 13

Medicare UPINF83718
Other010467585Aetna Nonhmo
Other010467585Standard Tax Id
Other010467585Aetna Hmo
Other271500099Primecare Medicaid
Medicare ID-Type UnspecifiedMM7423ME
Medicaid271500099ME
Other0100365YPME01NH · Anthem Bcbs New Hampshire
Other080140514Railroad Medicare
OtherF83718Harvard Pilgrim
Other6960100Cigna Healthcare
Other010467585Machigonne
Other027332Anthem Bcbs

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from NH Healthy Families, Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield.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

Dr. Michael N Gauthier 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 ID6800832072
PECOS Enrollment IDI20050629000030
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 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.

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.
256 services146 patients
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.
219 services184 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
170 services170 patients
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180
This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
25 services21 patients

Hospital Affiliations CMS Care Compare 2

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

York Hospital

Acute Care Hospitals · York, ME
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number200020
Location15 Hospital DriveYork, ME 03909 · York County
Emergency services Birthing friendly

Exeter Hospital Inc

Acute Care Hospitals · Exeter, NH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number300023
Location5 Alumni DriveExeter, NH 03833 · Rockingham County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 03909 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
$86.72 typical visit price
range $56.28 – $169.96
Typical copayment $21.68 (range $14.07 – $42.49)
Most-billed visit code 99203
Established Patient
$99.18 typical visit price
range $18.22 – $138.92
Typical copayment $24.79 (range $4.55 – $34.73)
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.

98.06/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.13
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 3

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
8 suppliers24 claims63 services$5.95 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
3 suppliers23 claims23 services$5.20 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
2 suppliers11 claims11 services$207.24 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 20

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

SARAH ELIZABETH NOHMER NP
Nurse Practitioner (Family)
127 LONG SANDS RD
YORK, ME 03909
York County (207) 363-8430
MEREDITH LEGG
Nurse Practitioner
127 LONG SANDS RD
YORK, ME 03909
York County (207) 351-3477
HEATHER EASTMAN PT, DPT
Physical Therapist
127 LONG SANDS RD
YORK, ME 03909
York County (207) 361-3888
PULMONOLOGY ASSOCIATES OF YORK HOSPITAL
Internal Medicine (Pulmonary Disease)
127 LONG SANDS RD
YORK, ME 03909
York County (207) 351-3715
ELINOR M KURZ NP
Nurse Practitioner
127 LONG SANDS RD
YORK, ME 03909
York County (207) 351-3777
MRS. HOLLY BRUNNER JAMES NP
Nurse Practitioner (Family)
127 LONG SANDS RD, SUITE 11
YORK, ME 03909
York County (207) 363-8430
DR. PRINCE CHUKWUDI MADUMERE MD
Family Medicine
127 LONG SANDS RD
YORK, ME 03909
York County (207) 363-8430
DR. SANDRA LEIGH CORBETT DO
Family Medicine
127 LONG SANDS RD, SUITE 11
YORK, ME 03909
York County (207) 363-8430

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 Gauthier's NPI number?

The NPI number for Michael Gauthier is 1154384485. It was assigned to this individual provider in the NPPES registry on April 8, 2006.

Where is Michael Gauthier located?

Michael Gauthier practices at 127 Long Sands Rd Suite 11, York, ME 03909. The listed phone number is (207) 363-8430.

What is Michael Gauthier's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Michael Gauthier enrolled in Medicare?

Yes. Michael Gauthier 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 Gauthier accept?

Health plans from Ambetter from NH Healthy Families, Anthem Blue Cross and Blue Sheld and Anthem Blue Cross and Blue Shield list Michael Gauthier 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 Gauthier affiliated with any hospitals?

According to CMS data, Michael Gauthier is affiliated with York Hospital and Exeter Hospital Inc.

When was this NPI record last updated?

The NPPES record for Michael Gauthier was last updated on April 12, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.