ANDREW J GILLIES MD
NPI 1174520563
Ophthalmology in Dedham, MA
NPI Status: Active since June 30, 2005
Contact Information
980 WASHINGTON ST
SUITE 120
DEDHAM, MA
ZIP 02026
Phone: (781) 251-2222
Fax: (781) 234-0279
- Individual
- Male
- Ophthalmology
- Accepts Insurance
- PECOS Enrolled
About ANDREW GILLIES
This page provides the complete NPI Profile along with additional information for Andrew Gillies, a provider established in Dedham, Massachusetts with a medical specialization in Ophthalmology. The healthcare provider is registered in the NPI registry with number 1174520563 assigned on June 2005. The practitioner's primary taxonomy code is 207W00000X with license number 55237 (MA). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1174520563
- Provider Name
- ANDREW J GILLIES MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 980 WASHINGTON ST SUITE 120 DEDHAM, MA 02026
- Location Phone
- (781) 251-2222
- Location Fax
- (781) 234-0279
- Mailing Address
- 980 WASHINGTON ST SUITE 120 DEDHAM, MA 02026
- Mailing Phone
- (781) 251-2222
- Mailing Fax
- (781) 234-0279
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-30-2005
- Last Update Date
- 11-15-2011
- Code Navigator
Ophthalmologists like Andrew Gillies specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.
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
Ophthalmology
- Taxonomy Code
- 207W00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 55237
- License State
- MA
- Taxonomy Description
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Pathway X HMO 6000/20%/8000 w/HSA - HMO
- Anthem Bronze Pathway X HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Pathway X HMO 7500/30%/10000 Value - HMO
- Anthem Bronze Pathway X HMO 8500/50%/9200 - HMO
- Anthem Gold Pathway X HMO 1000/20%/7500 - HMO
- Anthem Gold Pathway X HMO 2000/0%/6500 RxD - HMO
- Anthem Gold Pathway X HMO 2000/10%/4600 w/HSA - HMO
- Anthem Gold Pathway X HMO 2000/10%/7500 - HMO
- Anthem Gold Pathway X HMO 2000/20%/4600 w/HSA - HMO
- Anthem Gold Pathway X HMO 3000/0%/7500 RxD - HMO
- Anthem Gold Pathway X HMO 500/30%/9000 - HMO
- Anthem Platinum Pathway X HMO 250/10%/3500 - HMO
- Anthem Silver Pathway X HMO 2500/30%/10000 Value - HMO
- Anthem Silver Pathway X HMO 3000/30%/9000 Value - HMO
- Anthem Silver Pathway X HMO 3500/20%/10000 - HMO
- Anthem Silver Pathway X HMO 3500/20%/7250 w/HSA - HMO
- Anthem Silver Pathway X HMO 4000/0%/9000 - HMO
- Anthem Silver Pathway X HMO 4000/0%/9000 RxD - HMO
- Anthem Silver Pathway X HMO 4000/10%/7250 w/HSA - HMO
- Anthem Silver Pathway X HMO 4000/20%/8500 - HMO
- Blue Focus Bronze POS? 205 - POS
- Blue Focus Bronze POS? 705 - POS
- Blue Focus Bronze POS? Standard - POS
- Blue Focus Gold POS? 207 - POS
- Blue Focus Gold POS? 902 - POS
- Blue Focus Gold POS? Standard - POS
- Blue Focus Silver POS? 206 - POS
- Blue Focus Silver POS? 903 - POS
- Blue Focus Silver POS? Standard - POS
- Blue Preferred Bronze PPO? 201 - PPO
- Blue Preferred Bronze PPO? 202 - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Preferred Gold PPO? 204 - PPO
- Blue Preferred Gold PPO? 901 - PPO
- Blue Preferred Gold PPO? Standard - PPO
- Blue Preferred Security PPO? 200 - PPO
- Blue Preferred Silver PPO? 203 - PPO
- Blue Preferred Silver PPO? 308 - PPO
- Blue Preferred Silver PPO? Standard - PPO
- Blue Advantage Bronze PPO? 202 - PPO
- Blue Advantage Bronze PPO? 203 - PPO
- Blue Advantage Bronze PPO? Standard - PPO
- Blue Advantage Gold PPO? 309 - PPO
- Blue Advantage Gold PPO? 604 - PPO
- Blue Advantage Gold PPO? Standard - PPO
- Blue Advantage Silver PPO? 204 - PPO
- Blue Advantage Silver PPO? 501 - PPO
- Blue Advantage Silver PPO? Standard - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Preferred Gold PPO? Standard - PPO
- Blue Preferred Security PPO? 200 - PPO
- Blue Preferred Silver PPO? Standard - PPO
- MyBlue Bronze HMO? 902 - HMO
- MyBlue Bronze HMO? 904 - HMO
- MyBlue Bronze HMO? Standard - HMO
- MyBlue Gold HMO? 704 - HMO
- MyBlue Gold HMO? 804 - HMO
- MyBlue Gold HMO? Standard - HMO
- MyBlue Silver HMO? 705 - HMO
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- Blue Advantage Plus Gold? 803 - POS
- Blue Advantage Plus Gold? Standard - POS
- Blue Advantage Plus Silver? 202 - POS
- Blue Advantage Plus Silver? 605 - POS
- Blue Advantage Plus Silver? Standard - POS
- Blue Advantage Security HMO? 200 - HMO
- Blue Advantage Silver HMO? 205 - HMO
- Blue Advantage Silver HMO? 801 - HMO
- Blue Advantage Silver HMO? Standard - HMO
- MyBlue Health Bronze? 402 - HMO
- Connect 1500 Gold - EPO
- Connect 6000 Silver - EPO
- Connect 9800 Bronze - EPO
- HSA Qualified 7500 Bronze - Choice Network - EPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Choice Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Choice Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Choice Network - EPO
- Providence Oregon Standard Silver Plan - Signature Network - EPO
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.
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 |
|---|---|---|---|
| 27410 | OTHER (01) | CHILDREN'S MEDICAL SECURI | |
| J07034 | OTHER (01) | BLUE SHIELD INDEMNITY | |
| J07034 | OTHER (01) | BS-BLUE CARE ELECT | |
| 180009329 | OTHER (01) | RAILROAD MEDICARE | |
| 055237 | OTHER (01) | TUFTS SECURE HORIZONS | |
| 3031535 | OTHER (01) | MASS HEALTH (DIV MED SVCS | |
| 7538944 | OTHER (01) | CIGNA HEALTH CARE | |
| 7538944 | OTHER (01) | HEALTHSOURSCE MASSACHUSET | |
| 055237 | OTHER (01) | TUFTS BENEFIT ADMINISTRAT | |
| J07034 | OTHER (01) | HMO BLUE/BLUE CHOICE | |
| 15986 | OTHER (01) | HARVARD PILGRIM POS PPO | |
| B77257 | OTHER (01) | FIRST SENIORITY | |
| 055237 | OTHER (01) | TUFTS | |
| 055237 | OTHER (01) | TUFTS TOTAL HEALTH PLAN | |
| 08-00480 | OTHER (01) | UNITED HEALTHCARE(HMO&PPO | |
| 000600 | OTHER (01) | NEIGHBORHOOD HEALTH PLAN | |
| 055237 | OTHER (01) | TUFTS COMMONWEALTH PPO | |
| J07034 | OTHER (01) | BS-BLUE CARE 65 | |
| B77257 | MEDICARE UPIN (02) | ||
| J07034 | MEDICARE ID-TYPE UNSPECIFIED (04) |
Medicare Participation & PECOS Enrollment Status
Andrew Gillies 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
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
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Cataract surgery
Complex removal of cataract with insertion of prosthetic lens
Ct scan of cornea
Established patient complete exam of visual system
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient problem focused exam of visual system
Exam of visual field with extended testing
Extended exam of the back part of the eye with optic nerve drawing
Extended exam of the back part of the eye with retinal drawing
Imaging of front third of eye
Imaging of optic nerve
Imaging of retina
Incision to improve eye fluid flow
Measurement of corneal curvature and depth of eye
New patient complete exam of visual system
New patient problem focused exam of visual system
Photography of the retina
Removal of cataract with insertion of prosthetic lens
Removal of recurring cataract in lens capsule using a laser
Cataract surgery is a procedure to remove the lens of your eye when it becomes cloudy, which is called a cataract. A synthetic lens is then inserted to restore clear vision. The operation is typically done on an outpatient basis and is very safe and effective.
This service was performed for 304 patientsThis procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.
This service was performed 17 times for 15 patientsA CT scan of the cornea is a non-invasive imaging test that uses X-rays to capture detailed pictures of your eye's cornea. It helps in diagnosing diseases or damage, planning for surgery, or evaluating the results of a treatment. It's a safe and painless procedure.
This service was performed 122 times for 122 patientsAn 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.
This service was performed 1,070 times for 1,040 patientsThis 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.
This service was performed 153 times for 120 patientsThis 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.
This service was performed 192 times for 183 patientsThis is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
This service was performed 747 times for 456 patientsAn extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
This service was performed 121 times for 109 patientsThis procedure involves a detailed examination of the back part of your eye, focusing on the optic nerve, a crucial component for vision. A drawing or map of the optic nerve is created to help track any changes over time. This can help detect eye diseases early.
This service was performed 13 times for 13 patientsThis procedure involves a detailed examination of the back part of your eye, including the retina. It helps identify any abnormalities or issues. A retinal drawing is made to record findings. It's non-invasive and crucial for maintaining eye health.
This service was performed 16 times for 15 patientsImaging of the front third of the eye, also known as anterior segment imaging, captures detailed images of the eye's front part. This includes the iris, cornea, and lens. It's a non-invasive procedure that helps diagnose and monitor eye conditions.
This service was performed 11 times for 11 patientsImaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
This service was performed 319 times for 315 patientsImaging 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.
This service was performed 181 times for 168 patientsThis procedure, known as a trabeculectomy, involves creating a small opening in the eye to improve fluid flow. This can help lower eye pressure in conditions like glaucoma. It's a common, safe procedure to protect your eye health.
This service was performed 17 times for 12 patientsThis 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.
This service was performed 125 times for 125 patientsA new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
This service was performed 59 times for 59 patientsA new patient problem-focused exam of the visual system is a basic evaluation of your eyes and vision. It includes checking your eye movements, visual acuity, and general eye health. It helps detect any potential issues early for timely treatment.
This service was performed 40 times for 40 patientsPhotography 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.
This service was performed 15 times for 15 patientsThis 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.
This service was performed 173 times for 115 patientsThis procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.
This service was performed 43 times for 40 patientsPhysician 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 02026 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $144.11
- Minimum New Patient Price $63.72
- Maximum New Patient Price $189.86
- Average New Patient Copayment $36.02
- Minimum New Patient Copayment $15.93
- Maximum New Patient Copayment $47.46
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $78.84
- Minimum Established Patient Price $21.07
- Maximum Established Patient Price $155.29
- Average Established Patient Copayment $19.71
- Minimum Established Patient Copayment $5.26
- Maximum Established Patient Copayment $38.82
* 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.
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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 1174520563, we treat the final digit (3) 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 47. The final step is to find the difference between that total and the next multiple of ten (50 - 47 = 3).
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 47 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 8 providers are registered at the same or a nearby location.
DEDHAM, MA 02026
DEDHAM, MA 02026
DEDHAM, MA 02026
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174520563, enumerated as an "individual" on June 30, 2005.
The provider is located at 980 WASHINGTON ST SUITE 120 DEDHAM, MA 02026 and the phone number is (781) 251-2222.
Ophthalmology with taxonomy code 207W00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Blue Cross and. Please consult your insurance carrier or call the provider to verify.
