MR. RICHARD J MAILLOUX MD
NPI 1215976188
Internal Medicine - Gastroenterology in Beckley, WV

Q: What is Richard Mailloux's NPI number?

The NPI number for Richard Mailloux is 1215976188. It was assigned to this individual provider in the NPPES registry on June 6, 2006.

Q: What is Richard Mailloux's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Richard Mailloux was last updated on September 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 June 06, 2006PECOS EnrolledAccepts Medicare Assignment

66.29/100

CMS Quality Rating

DR. RICHARD MAILLOUX, 198 CARRIAGE DRIVE, BECKLEY, WV 25801(304) 256-4348(681) 207-5101 Get Directions Write a Review

NPPES record last updated: September 18, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mr. Richard J Mailloux Md NPPES

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

MR. RICHARD J MAILLOUX MD (NPI 1215976188) is an individual gastroenterology provider in Beckley, West Virginia, licensed in West Virginia (18094) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Camc Greenbrier Valley Medical Center, Inc, and is a graduate of Rutgers R W Johnson Medical School (cam/new Bruns/pisc) (1989).

NPPES Registry Identity

NPI1215976188

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameMR. RICHARD J MAILLOUXCredential: MD

Location AddressDR. RICHARD MAILLOUX, 198 CARRIAGE DRIVEBeckley, WV 25801-2804

Mailing AddressDr. Richard Mailloux, 198 Carriage DriveBeckley, WV 25801-2804 · (304) 256-4348 · Fax (681) 207-5101

Phone(304) 256-4348

Fax(681) 207-5101

Sole ProprietorNo

Medical School CMSRutgers R W Johnson Medical School (cam/new Bruns/pisc)Graduated 1989

Enumeration DateJune 6, 2006

Last NPPES UpdateSeptember 18, 2019

✔ NPI 1215976188 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in WV · 18094

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

DR. RICHARD MAILLOUX, Beckley, WV 25801

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Other Identifiers 5

Medicaid0088257000WV

Other0151526OH · Medicaid

Other000000691895KY · Anthem Bcbs

Other110103523Railroad Medicare

Medicaid64072697KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Highmark Blue Cross Blue Shield West Virginia.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

Mr. Richard J Mailloux 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 ID143242669

PECOS Enrollment IDI20051228000151

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 16

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 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.

207 services125 patients

Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito G0500

Moderate sedation is a method where a physician uses medication to help you relax during a gastrointestinal endoscopy. An independent trained observer will be present to monitor your vital signs and ensure your safety throughout the procedure. It's a common and safe practice.

179 services174 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

159 services63 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

88 services87 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

62 services61 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

52 services49 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.

47 services39 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

47 services45 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.

35 services18 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

33 services33 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

33 services33 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

30 services30 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

25 services25 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

18 services18 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

17 services17 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

13 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Camc Greenbrier Valley Medical Center, Inc

Acute Care Hospitals · Ronceverte, WV

2/5 CMS rating

OwnershipProprietary

CMS Certification Number510002

Location1320 Maplewood AvenueRonceverte, WV 24970 · Greenbrier County

Emergency services Birthing friendly

Raleigh General Hospital

Acute Care Hospitals · Beckley, WV

1/5 CMS rating

OwnershipProprietary

CMS Certification Number510070

Location1710 Harper RoadBeckley, WV 25801 · Raleigh County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25801 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

$124.46 typical visit price

range $53.20 – $164.59

Typical copayment $31.11 (range $13.30 – $41.14)

Most-billed visit code 99204

Established Patient

$94.81 typical visit price

range $16.47 – $133.29

Typical copayment $23.70 (range $4.11 – $33.32)

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.

66.29/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

74.12

Promoting Interoperability

Improvement Activities

Cost

90.65

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report

47%45 patients3/55-star benchmark: 87%

Colorectal Cancer Screening

71%602 patients4/55-star benchmark: 88%

Controlling High Blood Pressure

66%87 patients3/55-star benchmark: 91%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

88%65 patients1/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

77%2,288 patients3/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

18%956 patients1/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

41%900 patients2/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

22%1,511 patients2/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 22% · 619 patients

Patients screened: 29% · 619 patients

18%50 patients1/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

89%122 patients4/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 488 patients

Patients totalRate: 4% · 488 patients

4%488 patients4/55-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.

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 Richard Mailloux's NPI number?

The NPI number for Richard Mailloux is 1215976188. It was assigned to this individual provider in the NPPES registry on June 6, 2006.

Where is Richard Mailloux located?

Richard Mailloux practices at Dr. Richard Mailloux 198 Carriage Drive, Beckley, WV 25801. The listed phone number is (304) 256-4348.

What is Richard Mailloux's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Richard Mailloux enrolled in Medicare?

Yes. Richard Mailloux 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 Richard Mailloux accept?

Health plans from CareSource and Highmark Blue Cross Blue Shield West Virginia list Richard Mailloux 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 Richard Mailloux affiliated with any hospitals?

According to CMS data, Richard Mailloux is affiliated with Camc Greenbrier Valley Medical Center, Inc and Raleigh General Hospital.

When was this NPI record last updated?

The NPPES record for Richard Mailloux was last updated on September 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.