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GARY JAMES DUNCAN MD
NPI 1487150249
Family Medicine in Delaware, OH

Active since April 02, 2018PECOS EnrolledAccepts Medicare Assignment
81.3/100
CMS Quality Rating
454 W CENTRAL AVE, DELAWARE, OH 43015(740) 369-1010 Get Directions Write a Review

NPPES record last updated: September 18, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 25, 2022, Aug 4, 2021, Jul 13, 2021 (3 updates tracked since 2021).

About Gary James Duncan Md NPPES

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

GARY JAMES DUNCAN MD (NPI 1487150249) is an individual family medicine provider in Delaware, Ohio, licensed in Ohio (35.141372) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS, is affiliated with Riverside Methodist Hospital, and maintains a secondary practice location in Columbus.

NPPES Registry Identity

NPI1487150249
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameGARY JAMES DUNCANCredential: MD
Location Address454 W CENTRAL AVEDelaware, OH 43015-1486
Mailing AddressPo Box 7527Dublin, OH 43017-0727 · (614) 533-6497 · Fax (614) 533-0433
Phone(740) 369-1010
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical School At San AntonioGraduated 2018
Enumeration DateApril 2, 2018
Last NPPES UpdateSeptember 18, 20233 updates tracked since enumeration
NPPES CertifiedSeptember 18, 2023
✔ NPI 1487150249 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OH · 35.141372
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
454 W CENTRAL AVE, Delaware, OH 43015
Open in Google Maps ↗

Secondary Practice Location 1

Location 1697 Thomas LnColumbus, OH 43214-3931 · Phone (614) 566-6414 · Fax (614) 533-0433

Other Identifiers 1

Medicaid355024OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, MedMutual.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

Gary James Duncan 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 ID9335494087
PECOS Enrollment IDI20210811003438
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 6

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 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.
132 services67 patients
Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
80 services14 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.
69 services51 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
21 services21 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
14 services13 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
12 services12 patients

Hospital Affiliations CMS Care Compare 5

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

Riverside Methodist Hospital

Acute Care Hospitals · Columbus, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360006
Location3535 Olentangy River RdColumbus, OH 43214 · Franklin County
Emergency services Birthing friendly

Grant Medical Center

Acute Care Hospitals · Columbus, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number360017
Location111 South Grant AvenueColumbus, OH 43215 · Franklin County
Emergency services Birthing friendly

Doctors Hospital

Acute Care Hospitals · Columbus, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number360152
Location5100 West Broad StreetColumbus, OH 43228 · Franklin County
Emergency services Birthing friendly

Grady Memorial Hospital

Acute Care Hospitals · Delaware, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360210
Location561 West Central AvenueDelaware, OH 43015 · Delaware County
Emergency services Birthing friendly

Dublin Methodist Hospital

Acute Care Hospitals · Dublin, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360348
Location7500 Hospital AvenueDublin, OH 43016 · Franklin County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43015 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

81.3/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality73.58
Promoting Interoperability98
Improvement Activities40
Cost65.77

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.

DR. D MATTHEW KOEHLER MD
Internal Medicine
454 W CENTRAL AVE
DELAWARE, OH 43015
Delaware County (740) 369-1010
DR. GERALD THOMAS FRENCH MD
Internal Medicine
454 W CENTRAL AVE
DELAWARE, OH 43015
Delaware County (740) 369-1010
DELAWARE INTERNAL MEDICINE
Family Medicine
454 W CENTRAL AVE
DELAWARE, OH 43015
Delaware County (740) 369-1010

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 Gary Duncan's NPI number?

The NPI number for Gary Duncan is 1487150249. It was assigned to this individual provider in the NPPES registry on April 2, 2018.

Where is Gary Duncan located?

Gary Duncan practices at 454 W Central Ave, Delaware, OH 43015. The listed phone number is (740) 369-1010.

What is Gary Duncan's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Gary Duncan enrolled in Medicare?

Yes. Gary Duncan 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 Gary Duncan accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource and MedMutual list Gary Duncan 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 Gary Duncan affiliated with any hospitals?

According to CMS data, Gary Duncan is affiliated with Riverside Methodist Hospital, Grant Medical Center, Doctors Hospital, Grady Memorial Hospital and Dublin Methodist Hospital.

When was this NPI record last updated?

The NPPES record for Gary Duncan was last updated on September 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.