GARY GEORGE THEOFILIS DO, MBA, DABAM
NPI 1558672014
Pain Medicine - Interventional Pain Medicine in Cumming, GA

Q: What is Gary Theofilis's NPI number?

The NPI number for Gary Theofilis is 1558672014. It was assigned to this individual provider in the NPPES registry on June 29, 2010.

Q: What is Gary Theofilis's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Q: Is Gary Theofilis enrolled in Medicare?

No. Gary Theofilis has opted out of Medicare through July 26, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Gary Theofilis was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since June 29, 2010Opted out of Medicare · through Jul 26, 2028

6125 BROADWATER TRL, CUMMING, GA 30040(412) 477-4493 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Jul 21, 2022, May 14, 2017 (2 updates tracked since 2017).

On this page

About Gary George Theofilis Do, Mba, Dabam NPPES

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

GARY GEORGE THEOFILIS DO, MBA, DABAM (NPI 1558672014) is an individual interventional pain medicine provider in Cumming, Georgia, licensed in Georgia (74400) and active in the NPI registry since June 2010. He has opted out of Medicare through July 26, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1558672014

Entity TypeIndividualMale

Primary Taxonomy208VP0014X

Provider Legal NameGARY GEORGE THEOFILISCredential: DO, MBA, DABAM

Location Address6125 BROADWATER TRLCumming, GA 30040-9521

Mailing Address6125 Broadwater TrlCumming, GA 30040-9521 · (412) 477-4493

Phone(412) 477-4493

Sole ProprietorYes

Enumeration DateJune 29, 2010

Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration

✔ NPI 1558672014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians

Taxonomy Code208VP0014X

Licenses✔ Licensed in GA · 74400✔ Licensed in PA · OS01718

Definition

Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

Also ListedAnesthesiology · Addiction MedicineTaxonomy 207LA0401X · License OS01718 (PA), 74400 (GA)

6125 BROADWATER TRL, Cumming, GA 30040

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Gary George Theofilis Do, Mba, Dabam has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 26, 2018 through July 26, 2028.

Opt-Out Effective DateJuly 26, 2018

Opt-Out In Effect ThroughJuly 26, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30040 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

$130.64 typical visit price

range $56.84 – $172.43

Typical copayment $32.66 (range $14.21 – $43.10)

Most-billed visit code 99204

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

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.

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 Theofilis's NPI number?

The NPI number for Gary Theofilis is 1558672014. It was assigned to this individual provider in the NPPES registry on June 29, 2010.

Where is Gary Theofilis located?

Gary Theofilis practices at 6125 Broadwater Trl, Cumming, GA 30040. The listed phone number is (412) 477-4493.

What is Gary Theofilis's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Is Gary Theofilis enrolled in Medicare?

No. Gary Theofilis has opted out of Medicare through July 26, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Gary Theofilis was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.