MATTHEW T GAINES MD
NPI 1205802667
Hospitalist in Foley, AL

Active since February 27, 2006PECOS EnrolledAccepts Medicare Assignment
1613 N MCKENZIE ST, FOLEY, AL 36535(251) 949-3711(251) 949-3715 Get Directions Write a Review

NPPES record last updated: May 8, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 8, 2026, Nov 20, 2023 (2 updates tracked since 2023).

About Matthew T Gaines Md NPPES

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

MATTHEW T GAINES MD (NPI 1205802667) is an individual hospitalist provider in Foley, Alabama, licensed in Alabama (24491) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with University Of Mississippi Med Center, and maintains a secondary practice location in Brookhaven.

NPPES Registry Identity

NPI1205802667
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameMATTHEW T GAINESCredential: MD
Location Address1613 N MCKENZIE STFoley, AL 36535-2247
Mailing AddressPo Box 689022Franklin, TN 37068-9022 · (251) 949-3711 · Fax (251) 949-3715
Fax(251) 949-3715
Sole ProprietorNo
Medical School CMSUniversity Of South Alabama College Of MedicineGraduated 2001
Enumeration DateFebruary 27, 2006
Last NPPES UpdateMay 8, 20262 updates tracked since enumeration
NPPES CertifiedMay 8, 2026
NPI 1205802667 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
Licenses Licensed in AL · 24491 Licensed in MS · 18092
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License 18092 (MS)
1613 N MCKENZIE ST, Foley, AL 36535

Secondary Practice Location 1

Location 1427 Highway 51 NBrookhaven, MS 39601-2350 · Phone (601) 833-6011

Other Identifiers 1

Medicaid00125422MS

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

Matthew T 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 ID840251294
PECOS Enrollment IDI20041020000330, I20081020000247
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 8

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
316 services162 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
290 services249 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
225 services115 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
180 services159 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
91 services89 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
60 services32 patients

Hospital Affiliations CMS Care Compare 4

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

University Of Mississippi Med Center

Acute Care Hospitals · Jackson, MS
2/5 CMS rating
OwnershipGovernment - State
CMS Certification Number250001
Location2500 N State StJackson, MS 39216 · Hinds County
Emergency services Birthing friendly

St Dominic-Jackson Memorial Hospital

Acute Care Hospitals · Jackson, MS
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number250048
Location969 Lakeland DrJackson, MS 39216 · Hinds County
Emergency services Birthing friendly

King's Daughters Medical Center-Brookhaven

Acute Care Hospitals · Brookhaven, MS
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number250057
Location427 Highway 51 NorthBrookhaven, MS 39601 · Lincoln County
Emergency services Birthing friendly

Franklin County Memorial Hospital

Critical Access Hospitals · Meadville, MS
OwnershipGovernment - Local
CMS Certification Number251330
Location40 Union Church RdMeadville, MS 39653 · Franklin County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36535 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
$122.31 typical visit price
range $52.65 – $161.63
Typical copayment $30.57 (range $13.16 – $40.40)
Most-billed visit code 99204
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
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.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
17%206 patients1/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

Hospital bed, fixed height, with any type side rails, with mattress E0250
DME-Hospital Beds · category DB000N
1 supplier11 claims11 services$42.40 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier15 claims15 services$19.85 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers26 claims26 services$110.68 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.

Radiology (Diagnostic Radiology)
1613 N MCKENZIE ST
FOLEY, AL 36535
Nurse Anesthetist, Certified Registered
1613 N MCKENZIE ST
FOLEY, AL 36535
Student in an Organized Health Care Education/Training Program
1613 N MCKENZIE ST
FOLEY, AL 36535
Anesthesiology
1613 N MCKENZIE ST
FOLEY, AL 36535
Emergency Medicine
1613 N MCKENZIE ST
FOLEY, AL 36535
General Acute Care Hospital
1613 N MCKENZIE ST
FOLEY, AL 36535
Specialist
1613 N MCKENZIE ST
FOLEY, AL 36535
Internal Medicine (Pulmonary Disease)
1613 N MCKENZIE ST
FOLEY, AL 36535

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 Matthew Gaines's NPI number?

The NPI number for Matthew Gaines is 1205802667. It was assigned to this individual provider in the NPPES registry on February 27, 2006.

Where is Matthew Gaines located?

Matthew Gaines practices at 1613 N Mckenzie St, Foley, AL 36535. The listed phone number is (251) 949-3711.

What is Matthew Gaines's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Matthew Gaines enrolled in Medicare?

Yes. Matthew Gaines 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 Matthew Gaines accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee list Matthew Gaines 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 Matthew Gaines affiliated with any hospitals?

According to CMS data, Matthew Gaines is affiliated with University Of Mississippi Med Center, St Dominic-Jackson Memorial Hospital, King's Daughters Medical Center-Brookhaven and Franklin County Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Matthew Gaines was last updated on May 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.