PAUL G WELCH MD
NPI 1548259146
Internal Medicine - Nephrology in Martinsburg, WV

Active since October 17, 2005PECOS EnrolledAccepts Medicare Assignment
80.23/100
CMS Quality Rating
103 MARCLEY DR, MARTINSBURG, WV 25401(304) 263-0911(304) 263-0896 Get Directions Write a Review

NPPES record last updated: May 12, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Paul G Welch Md NPPES

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

PAUL G WELCH MD (NPI 1548259146) is an individual nephrology provider in Martinsburg, West Virginia, licensed in Maryland (D0036460) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Meritus Medical Center, and is a graduate of Uniformed Services Uhs Fe Hebert School Of Med (1983).

NPPES Registry Identity

NPI1548259146
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NamePAUL G WELCHCredential: MD
Location Address103 MARCLEY DRMartinsburg, WV 25401-2977
Mailing Address12931 Oak Hill AveHagerstown, MD 21742-2914 · (301) 797-9600 · Fax (301) 797-3854
Fax(304) 263-0896
Sole ProprietorNo
Medical School CMSUniformed Services Uhs Fe Hebert School Of MedGraduated 1983
Enumeration DateOctober 17, 2005
Last NPPES UpdateMay 12, 2026
NPPES CertifiedMay 12, 2026
NPI 1548259146 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Licenses Licensed in MD · D0036460 Licensed in WV · 21663
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
103 MARCLEY DR, Martinsburg, WV 25401

Other Identifiers 2

Medicaid3810000572WV
Medicaid405937900MD

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

Paul G Welch 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 ID6901870989
PECOS Enrollment IDI20040825000136, I20040928001022, I20171116002084
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 12

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.

Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
563 services71 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.
373 services261 patients
Dialysis services, per day, less than full month service (20 years or older) 90970
Dialysis is a treatment that replicates some functions of healthy kidneys when they're not working properly. It helps to remove waste, salt, and excess water from your body and maintain a safe level of certain chemicals in your blood. This service, for patients aged 20 or older, is provided on a daily basis for less than a full month.
306 services16 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.
200 services101 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.
157 services90 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.
77 services76 patients

Hospital Affiliations CMS Care Compare 4

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

Meritus Medical Center

Acute Care Hospitals · Hagerstown, MD
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number210001
Location11116 Medical Campus RoadHagerstown, MD 21742 · Washington County
Emergency services Birthing friendly

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

Jefferson Medical Center

Critical Access Hospitals · Ranson, WV
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number511319
Location300 South Preston StreetRanson, WV 25438 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25401 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.

80.23/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality58.17
Promoting Interoperability100
Improvement Activities40
Cost56.34

Reported Quality Measures

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.
68%3,327 patients1/55-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.
97%1,180 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…
1%1,029 patients1/55-star benchmark: 96%
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.
97%1,180 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.
75%1,029 patients4/55-star benchmark: 99%
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…
31%879 patients2/55-star benchmark: 97%
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: 96% · 285 patients
Patients tobacco: 88% · 285 patients
20%30 patients1/55-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…
72%1,029 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…
0%1,029 patients1/55-star benchmark: 59%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 498 patients
0%498 patients5/55-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.

Referred Medical Equipment & Supplies CMS DME claims 4

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

Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
4 suppliers48 claims1,980 services$0.33 avg. paid by Medicare
Mycophenolate mofetil, oral, 250 mg J7517
Treatment-Treatment - Miscellaneous · category RX029N
4 suppliers43 claims3,630 services$0.20 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
4 suppliers47 claims47 services$18.96 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
4 suppliers52 claims55 services$12.63 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 5

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

Internal Medicine (Nephrology)
103 MARCLEY DR
MARTINSBURG, WV 25401
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
103 MARCLEY DR
MARTINSBURG, WV 25401
Nurse Practitioner
103 MARCLEY DR
MARTINSBURG, WV 25401
Social Worker (Clinical)
103 MARCLEY DR
MARTINSBURG, WV 25401
Nurse Practitioner (Family)
103 MARCLEY DR
MARTINSBURG, WV 25401

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 Paul Welch's NPI number?

The NPI number for Paul Welch is 1548259146. It was assigned to this individual provider in the NPPES registry on October 17, 2005.

Where is Paul Welch located?

Paul Welch practices at 103 Marcley Dr, Martinsburg, WV 25401. The listed phone number is (304) 263-0911.

What is Paul Welch's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Paul Welch enrolled in Medicare?

Yes. Paul Welch 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 Paul Welch accept?

Health plans from Highmark Blue Cross Blue Shield West Virginia list Paul Welch 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 Paul Welch affiliated with any hospitals?

According to CMS data, Paul Welch is affiliated with Meritus Medical Center, Berkeley Medical Center, Valley Health War Memorial Hospital and Jefferson Medical Center.

When was this NPI record last updated?

The NPPES record for Paul Welch was last updated on May 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.