DR. MARK GALBRAITH MD
NPI 1255336723
Internal Medicine - Infectious Disease in Winchester, VA

Active since June 20, 2005PECOS EnrolledAccepts Medicare Assignment
104 SELMA DR, WINCHESTER, VA 22601(540) 678-2800 Get Directions Write a Review

NPPES record last updated: February 27, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 27, 2021, Sep 3, 2020 (2 updates tracked since 2020).

About Dr. Mark Galbraith Md NPPES

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

DR. MARK GALBRAITH MD (NPI 1255336723) is an individual infectious disease provider in Winchester, Virginia, licensed in Virginia (0101042357) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with Winchester Medical Center, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (1976).

NPPES Registry Identity

NPI1255336723
Entity TypeIndividualMale
Primary Taxonomy207RI0200X
Provider Legal NameDR. MARK GALBRAITHCredential: MD
Location Address104 SELMA DRWinchester, VA 22601-3834
Mailing Address104 Selma DrWinchester, VA 22601-3834 · (540) 678-2800
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 1976
Enumeration DateJune 20, 2005
Last NPPES UpdateFebruary 27, 20212 updates tracked since enumeration
NPPES CertifiedFebruary 27, 2021
NPI 1255336723 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
License Licensed in VA · 0101042357
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
Also ListedInternal MedicineTaxonomy 207R00000X · License 0101042357 (VA)
104 SELMA DR, Winchester, VA 22601

Other Identifiers 8

Other43944VA · Communityhealth Sentara
Medicaid0071617000WV
Other2119574VA · Mamsi
Medicaid006030459VA
Medicaid546811600MD
Other082424VA · Southern Health
Other051146VA · Anthem Bcbs
Other502796VA · Ncppo

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. Mark Galbraith 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 ID345143863
PECOS Enrollment IDI20100318000207
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 24

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 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.
703 services267 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.
440 services248 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.
334 services290 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.
249 services162 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
241 services130 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
161 services131 patients

Hospital Affiliations CMS Care Compare 5

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

Winchester Medical Center

Acute Care Hospitals · Winchester, VA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490005
Location1840 Amherst StWinchester, VA 22601 · Winchester City County
Emergency services Birthing friendly

Warren Memorial Hospital

Acute Care Hospitals · Front Royal, VA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490033
Location351 Valley Health WayFront Royal, VA 22630 · Warren County
Emergency services

Shenandoah Memorial Hospital

Critical Access Hospitals · Woodstock, VA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number491305
Location759 South Main StreetWoodstock, VA 22664 · Shenandoah County
Emergency services

Berkeley Medical Center

Acute Care Hospitals · Martinsburg, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510008
Location2500 Hospital DriveMartinsburg, WV 25401 · Berkeley County
Emergency services Birthing friendly

Valley Health War Memorial Hospital

Critical Access Hospitals · Berkeley Springs, WV
OwnershipVoluntary non-profit - Private
CMS Certification Number511309
Location1 Healthy WayBerkeley Springs, WV 25411 · Morgan County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22601 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
$129.04 typical visit price
range $56.19 – $170.30
Typical copayment $32.26 (range $14.04 – $42.57)
Most-billed visit code 99204
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
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

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
28%301 patients2/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
29%763 patients2/55-star benchmark: 85%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
88%1,179 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
95%194 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
32%596 patients2/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
48%682 patients3/55-star benchmark: 90%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
33%1,009 patients2/55-star benchmark: 88%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
24%597 patients1/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
4%597 patients1/55-star benchmark: 79%
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 6

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

Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) A4221
DME-Other DME · category DE017N
2 suppliers24 claims74 services$18.38 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
5 suppliers12 claims20 services$5.99 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
5 suppliers18 claims67 services$2.09 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
4 suppliers18 claims19 services$98.21 avg. paid by Medicare
Injection, immune globulin (hizentra), 100 mg J1559
Treatment-Injections and Infusions (nononcologic) · category RI008N
2 suppliers24 claims7,460 services$9.51 avg. paid by Medicare
Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each K0552
DME-Other DME · category DE000N
2 suppliers24 claims85 services$2.37 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.

Family Medicine
104 SELMA DR
WINCHESTER, VA 22601
Nurse Practitioner (Acute Care)
104 SELMA DR
WINCHESTER, VA 22601
Clinical Medical Laboratory
104 SELMA DR
WINCHESTER, VA 22601
Internal Medicine
104 SELMA DR
WINCHESTER, VA 22601
Family Medicine
104 SELMA DR
WINCHESTER, VA 22601
Internal Medicine
104 SELMA DR
WINCHESTER, VA 22601
Physician Assistant
104 SELMA DR
WINCHESTER, VA 22601
Nurse Practitioner (Family)
104 SELMA DR
WINCHESTER, VA 22601

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 Mark Galbraith's NPI number?

The NPI number for Mark Galbraith is 1255336723. It was assigned to this individual provider in the NPPES registry on June 20, 2005.

Where is Mark Galbraith located?

Mark Galbraith practices at 104 Selma Dr, Winchester, VA 22601. The listed phone number is (540) 678-2800.

What is Mark Galbraith's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Mark Galbraith enrolled in Medicare?

Yes. Mark Galbraith 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 Mark Galbraith accept?

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

According to CMS data, Mark Galbraith is affiliated with Winchester Medical Center, Warren Memorial Hospital, Shenandoah Memorial Hospital, Berkeley Medical Center and Valley Health War Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Mark Galbraith was last updated on February 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.