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WILLIAM RUSSELL GILES JR. MD
NPI 1386662419
Internal Medicine in Gun Barrel City, TX

Active since July 17, 2006PECOS EnrolledAccepts Medicare Assignment
97.58/100
CMS Quality Rating
126 W MAIN ST, GUN BARREL CITY, TX 75156(903) 713-1582(903) 713-1579 Get Directions Write a Review

NPPES record last updated: January 8, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About William Russell Giles Jr. Md NPPES

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

WILLIAM RUSSELL GILES JR. MD (NPI 1386662419) is an individual internal medicine provider in Gun Barrel City, Texas, licensed in Texas (M0730) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Ut Health East Texas Tyler Regional Hospital, and is a graduate of University Of Texas Medical School At Houston (2001).

NPPES Registry Identity

NPI1386662419
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameWILLIAM RUSSELL GILES JR.Credential: MD
Location Address126 W MAIN STGun Barrel City, TX 75156-5297
Mailing AddressPo Box 9477Tyler, TX 75711-9477 · (903) 713-1582 · Fax (903) 713-1579
Phone(903) 713-1582
Fax(903) 713-1579
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical School At HoustonGraduated 2001
Enumeration DateJuly 17, 2006
Last NPPES UpdateJanuary 8, 2009
✔ NPI 1386662419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in TX · M0730
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.
126 W MAIN ST, Gun Barrel City, TX 75156
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Other Identifiers 7

Other8S5838TX · Blue Cross
Medicare UPINI27800TX
Medicaid174192802TX
OtherP00339673TX · Railroad Medicare
Medicare PINP00339673TX
Medicare PIN8G7752TX
Medicare PIN8L1585TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.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 Russell Giles Jr. 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 ID3173561974
PECOS Enrollment IDI20050421001170
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

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.

Outpatient heart rehabilitation with electrocardiogram (ecg) monitoring, quality health care professional services 93798
Outpatient heart rehabilitation involves regular visits to a clinic for heart health improvement after a cardiac event. During these sessions, an electrocardiogram (ECG) monitors heart activity, while healthcare professionals provide personalized care and education on lifestyle changes, ensuring a safe recovery and reducing future heart risks.
543 services35 patients

Hospital Affiliations CMS Care Compare 4

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

Ut Health East Texas Tyler Regional Hospital

Acute Care Hospitals · Tyler, TX
1/5 CMS rating
OwnershipProprietary
CMS Certification Number450083
Location1000 South Beckham AveTyler, TX 75701 · Smith County
Emergency services Birthing friendly

Christus Mother Frances Hospital

Acute Care Hospitals · Tyler, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450102
Location800 East DawsonTyler, TX 75701 · Smith County
Emergency services Birthing friendly

Ut Health East Texas Athens Hospital

Acute Care Hospitals · Athens, TX
2/5 CMS rating
OwnershipProprietary
CMS Certification Number450389
Location2000 South Palestine StAthens, TX 75751 · Henderson County
Emergency services Birthing friendly
4/5 CMS rating
OwnershipGovernment - State
CMS Certification Number450690
Location11937 Us Highway 271Tyler, TX 75708 · Smith County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75156 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

97.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.53
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

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.
94%6,242 patients4/55-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…
35%394 patients2/55-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.
96%246 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.
96%1,183 patients4/55-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
88%335 patients4/55-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
53%1,642 patients3/55-star benchmark: 88%
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
Patients screenedForUse: 100% · 1,876 patients
Patients tobacco: 83% · 492 patients
99%1,876 patients5/55-star benchmark: 98%
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…
74%1,183 patients3/55-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…
18%1,183 patients1/55-star benchmark: 79%
Tobacco Use and Help with Quitting Among Adolescents
The percentage of adolescents 12 to 20 years of age with a primary care visit during the measurement year for whom tobacco use status was documented and received help with quitting if identified as a tobacco user
94%34 patients
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 9

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
8 suppliers33 claims99 services$5.77 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
4 suppliers16 claims96 services$2.25 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 supplier38 claims38 services$18.51 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
3 suppliers60 claims60 services$87.50 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
2 suppliers28 claims30 services$27.65 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
4 suppliers30 claims5,697 services$0.03 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 2

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

CHARLES DERICK COOPER NP
Nurse Practitioner
126 W MAIN ST
GUN BARREL CITY, TX 75156
Henderson County (903) 887-1092
ASIYA MAHMOOD M.D
Internal Medicine
126 W MAIN ST, BAY 4
GUN BARREL CITY, TX 75156
Henderson County (903) 713-1582

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 William Giles's NPI number?

The NPI number for William Giles is 1386662419. It was assigned to this individual provider in the NPPES registry on July 17, 2006.

Where is William Giles located?

William Giles practices at 126 W Main St, Gun Barrel City, TX 75156. The listed phone number is (903) 713-1582.

What is William Giles's specialty?

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

Is William Giles enrolled in Medicare?

Yes. William Giles 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 William Giles accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list William Giles 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 William Giles affiliated with any hospitals?

According to CMS data, William Giles is affiliated with Ut Health East Texas Tyler Regional Hospital, Christus Mother Frances Hospital, Ut Health East Texas Athens Hospital and The University Of Texas Health Science Center At Tyler.

When was this NPI record last updated?

The NPPES record for William Giles was last updated on January 8, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.