WILLIAM M GAINES MD
NPI 1184684078
Internal Medicine in Auburn, MA

Q: What is William Gaines's NPI number?

The NPI number for William Gaines is 1184684078. It was assigned to this individual provider in the NPPES registry on March 24, 2006.

Q: What is William Gaines's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for William Gaines was last updated on March 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 March 24, 2006PECOS EnrolledAccepts Medicare Assignment

385 SOUTHBRIDGE ST, AUBURN, MA 01501(508) 721-1170(508) 832-0859 Get Directions Write a Review

NPPES record last updated: March 14, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About William M Gaines Md NPPES

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

WILLIAM M GAINES MD (NPI 1184684078) is an individual internal medicine provider in Auburn, Massachusetts, licensed in Massachusetts (56092) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS and is a graduate of Js Weill Medical College, Cornell University (1983).

NPPES Registry Identity

NPI1184684078

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameWILLIAM M GAINESCredential: MD

Location Address385 SOUTHBRIDGE STAuburn, MA 01501-2498

Mailing Address5 Neponset St Fl St2Worcester, MA 01606-2714 · (508) 368-5532 · Fax (508) 832-0859

Phone(508) 721-1170

Fax(508) 832-0859

Sole ProprietorNo

Medical School CMSJs Weill Medical College, Cornell UniversityGraduated 1983

Enumeration DateMarch 24, 2006

Last NPPES UpdateMarch 14, 2019

✔ NPI 1184684078 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in MA · 56092

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.

385 SOUTHBRIDGE ST, Auburn, MA 01501

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Other Identifiers 18

Other7401287Aetna Us Healthcare

Other042472266One Health Plan

Other042472266Private Healthcare System

Other784135Mvp Health Care

Other9900247Fallon Community Health P

Other1060231First Health

Other4290501Cigna Health Plan

Other0400948Evercare

OtherJ06139Blue Care Elect

Other26819Childrens Med Sec Plan

Medicaid3018598MA

OtherJ06139Blue Shield Hmo Blue

OtherJ06139Medicare B

Other110175376Railroad Medicare

Other042472266Healthcare Value Mgmt

Other26819Healthy Start

OtherAA1298Harvard Pilgrim Healthcar

OtherJ06139Blue Shield Indemnity

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include 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

William M Gaines 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 ID2062554587

PECOS Enrollment IDI20100122000019

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.

29 services28 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.

28 services28 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

14 services13 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.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01501 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

$134.47 typical visit price

range $58.86 – $177.36

Typical copayment $33.61 (range $14.71 – $44.34)

Most-billed visit code 99204

Established Patient

$103.48 typical visit price

range $19.11 – $144.84

Typical copayment $25.87 (range $4.77 – $36.21)

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.

Referred Medical Equipment & Supplies CMS DME claims 10

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

11 suppliers32 claims67 services$5.89 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

5 suppliers21 claims21 services$0.94 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

2 suppliers16 claims16 services$33.49 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

3 suppliers11 claims11 services$69.70 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

3 suppliers11 claims27 services$27.94 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

2 suppliers13 claims13 services$44.35 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.

DR. DEBBORAH E. SMYTH PHD

Psychologist