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DR. JOSEPH CLAYTON GATHE JR. M.D.
NPI 1366436263
Internal Medicine - Infectious Disease in Houston, TX

Active since September 07, 2005PECOS EnrolledAccepts Medicare Assignment
39.85/100
CMS Quality Rating
4900 FANNIN ST, HOUSTON, TX 77004(713) 526-9821(713) 526-0614 Get Directions Write a Review

NPPES record last updated: December 16, 2008. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Joseph Clayton Gathe Jr. M.d. NPPES

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

DR. JOSEPH CLAYTON GATHE JR. M.D. (NPI 1366436263) is an individual infectious disease provider in Houston, Texas, licensed in Texas (F9471) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Memorial Hermann - Texas Medical Center, and is a graduate of Baylor College Of Medicine (1981).

NPPES Registry Identity

NPI1366436263
Entity TypeIndividualMale
Primary Taxonomy207RI0200X
Provider Legal NameDR. JOSEPH CLAYTON GATHE JR.Credential: M.D.
Location Address4900 FANNIN STHouston, TX 77004-5706
Mailing Address4900 Fannin StHouston, TX 77004-5706 · (713) 526-9821 · Fax (713) 526-0614
Phone(713) 526-9821
Fax(713) 526-0614
Sole ProprietorNo
Medical School CMSBaylor College Of MedicineGraduated 1981
Enumeration DateSeptember 7, 2005
Last NPPES UpdateDecember 16, 2008
✔ NPI 1366436263 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
License✔ Licensed in TX · F9471
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.
4900 FANNIN ST, Houston, TX 77004
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Other Identifiers 3

Medicare PIN00N85ETX
Medicare UPINC16024TX
Medicaid123131805TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, WellPoint.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Joseph Clayton Gathe Jr. M.d. 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 ID7315978855
PECOS Enrollment IDI20050824001166
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.

Medicare Billing Reassignment

Medicare enrollment records show Joseph Gathe reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Joseph C.Gathe,jr.,m.D.,p.A,
Same address
Infectious Disease
4900 FANNIN ST
Houston, TX 77004
  • Reassigned Medicare billing, Texas enrollment
  • Medicare enrollment name: Joseph C.Gathe,jr MD PA
NPI 1871620070 (713) 526-9821

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 10

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.
1,345 services136 patients
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.
930 services154 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.
488 services188 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.
179 services139 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.
161 services91 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.
109 services45 patients

Hospital Affiliations CMS Care Compare 2

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

Memorial Hermann - Texas Medical Center

Acute Care Hospitals · Houston, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450068
Location6411 FanninHouston, TX 77030 · Harris County
Emergency services Birthing friendly

Hca Houston Healthcare Medical Center

Acute Care Hospitals · Houston, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number450659
Location1313 Hermann DrHouston, TX 77004 · Harris County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77004 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
$134.06 typical visit price
range $58.24 – $176.98
Typical copayment $33.51 (range $14.56 – $44.24)
Most-billed visit code 99204
Established Patient
$102.71 typical visit price
range $18.60 – $143.93
Typical copayment $25.67 (range $4.65 – $35.98)
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.

39.85/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality40
Improvement Activities0
Cost49.85

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…
94%187 patients4/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
2%249 patients1/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%2,093 patients5/55-star benchmark: 100%
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.
61%3,468 patients3/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
2%261 patients1/55-star benchmark: 98%
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.
100%22 patients5/55-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.
20%453 patients1/55-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
100%138 patients5/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%344 patients5/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
13%237 patients1/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
72%581 patients3/55-star benchmark: 100%
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…
87%453 patients4/55-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%453 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 5

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
1 supplier11 claims44 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
4 suppliers21 claims74 services$6.79 avg. paid by Medicare
Injection, immune globulin (hizentra), 100 mg J1559
Treatment-Injections and Infusions (nononcologic) · category RI008N
1 supplier11 claims4,400 services$9.48 avg. paid by Medicare
Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each K0552
DME-Other DME · category DE000N
1 supplier11 claims44 services$2.37 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier11 claims11 services$215.80 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 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARL C MAYBERRY PHYSICIANS ASSISTANT
Physician Assistant (Medical)
4900 FANNIN ST
HOUSTON, TX 77004
Harris County (713) 526-9821
THERAPEUTIC CONCEPTS, P.A.
Clinic/Center (Infusion Therapy)
4900 FANNIN ST
HOUSTON, TX 77004
Harris County (713) 522-2273
JOSEPH C.GATHE,JR.,M.D.,P.A,
Internal Medicine (Infectious Disease)
4900 FANNIN ST
HOUSTON, TX 77004
Harris County (713) 526-9821

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 Joseph Gathe's NPI number?

The NPI number for Joseph Gathe is 1366436263. It was assigned to this individual provider in the NPPES registry on September 7, 2005.

Where is Joseph Gathe located?

Joseph Gathe practices at 4900 Fannin St, Houston, TX 77004. The listed phone number is (713) 526-9821.

What is Joseph Gathe's specialty?

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

Is Joseph Gathe enrolled in Medicare?

Yes. Joseph Gathe 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.

Which organization bills Medicare for Joseph Gathe's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Joseph Gathe reassigns Medicare benefits to Joseph C.Gathe,jr.,m.D.,p.A, (Houston, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Joseph Gathe's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Joseph Gathe accept?

Health plans from Blue Cross and Blue Shield of Texas and WellPoint list Joseph Gathe 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 Joseph Gathe affiliated with any hospitals?

According to CMS data, Joseph Gathe is affiliated with Memorial Hermann - Texas Medical Center and Hca Houston Healthcare Medical Center.

When was this NPI record last updated?

The NPPES record for Joseph Gathe was last updated on December 16, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.