DR. MICHAEL RAYMOND GAGNON MD
NPI 1164525598
Ophthalmology in Pleasanton, CA

Active since September 07, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
5575 W LAS POSITAS BLVD, SUITE 240, PLEASANTON, CA 94588(925) 460-5000 Get Directions Write a Review

NPPES record last updated: May 9, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Michael Raymond Gagnon Md NPPES

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

DR. MICHAEL RAYMOND GAGNON MD (NPI 1164525598) is an individual ophthalmology provider in Pleasanton, California, licensed in California (A95523) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS and is a graduate of Creighton University School Of Medicine (2001).

NPPES Registry Identity

NPI1164525598
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. MICHAEL RAYMOND GAGNONCredential: MD
Location Address5575 W LAS POSITAS BLVD, SUITE 240Pleasanton, CA 94588
Mailing Address5575 W Las Positas Blvd, Suite 240Pleasanton, CA 94588 · (925) 460-5000
Sole ProprietorNo
Medical School CMSCreighton University School Of MedicineGraduated 2001
Enumeration DateSeptember 7, 2006
Last NPPES UpdateMay 9, 2013
NPI 1164525598 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses Licensed in CA · A95523 Licensed in UT · 5852453
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
5575 W LAS POSITAS BLVD, Pleasanton, CA 94588

Other Identifiers 1

Medicare UPIN132664

Accepted 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 Raymond Gagnon 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 ID4183650146
PECOS Enrollment IDI20070828001077
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 21

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 complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
1,231 services1,100 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
881 services749 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
801 services728 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.
696 services567 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
449 services324 patients
Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
412 services247 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94588 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
$153.83 typical visit price
range $69.00 – $202.35
Typical copayment $38.45 (range $17.25 – $50.58)
Most-billed visit code 99204
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
Most-billed visit code 99213
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Frames, purchases V2020
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier14 claims14 services$60.09 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.

Nurse Practitioner (Women's Health)
5575 W LAS POSITAS BLVD, #330
PLEASANTON, CA 94588
Dermatology
5575 W LAS POSITAS BLVD, 220
PLEASANTON, CA 94588
Surgery (Surgical Oncology)
5575 W LAS POSITAS BLVD, 270
PLEASANTON, CA 94588
Family Medicine
5575 W LAS POSITAS BLVD, # 130
PLEASANTON, CA 94588
Surgery
5575 W LAS POSITAS BLVD, #270
PLEASANTON, CA 94588
Internal Medicine
5575 W LAS POSITAS BLVD, #130
PLEASANTON, CA 94588
Optometrist
5575 W LAS POSITAS BLVD, #240
PLEASANTON, CA 94588
Internal Medicine
5575 W LAS POSITAS BLVD, #130
PLEASANTON, CA 94588

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 Gagnon's NPI number?

The NPI number for Michael Gagnon is 1164525598. It was assigned to this individual provider in the NPPES registry on September 7, 2006.

Where is Michael Gagnon located?

Michael Gagnon practices at 5575 W Las Positas Blvd Suite 240, Pleasanton, CA 94588. The listed phone number is (925) 460-5000.

What is Michael Gagnon's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Michael Gagnon enrolled in Medicare?

Yes. Michael Gagnon 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 Gagnon accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 1 other insurer list Michael Gagnon 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 Michael Gagnon was last updated on May 9, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.