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MALLORY GAUTHIER PHYSICIAN ASSISTANT
NPI 1598277907
Physician Assistant in Carbondale, IL

Active since October 26, 2017PECOS Enrolled
207 W JACKSON ST STE 201, CARBONDALE, IL 62901(618) 457-2963(618) 457-2992 Get Directions Write a Review

NPPES record last updated: April 20, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Apr 20, 2026, Oct 18, 2021, Apr 22, 2020 and 2 more (5 updates tracked since 2017).

About Mallory Gauthier Physician Assistant NPPES

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

MALLORY GAUTHIER PHYSICIAN ASSISTANT (NPI 1598277907) is an individual physician assistant in Carbondale, Illinois, licensed in Illinois (085006422) and active in the NPI registry since October 2017. She is enrolled in Medicare PECOS and is a graduate of Southern Illinois University School Of Medicine (2017).

NPPES Registry Identity

NPI1598277907
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMALLORY GAUTHIERCredential: PHYSICIAN ASSISTANT
Location Address207 W JACKSON ST STE 201Carbondale, IL 62901-1408
Mailing Address207 W Jackson St Ste 201Carbondale, IL 62901-1408 · (618) 457-2963 · Fax (618) 457-2992
Phone(618) 457-2963
Fax(618) 457-2992
Sole ProprietorNo
Medical School CMSSouthern Illinois University School Of MedicineGraduated 2017
Enumeration DateOctober 26, 2017
Last NPPES UpdateApril 20, 20265 updates tracked since enumeration
NPPES CertifiedApril 20, 2026
✔ NPI 1598277907 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in IL · 085006422
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
207 W JACKSON ST STE 201, Carbondale, IL 62901
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mallory Gauthier Physician Assistant is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5890052690
PECOS Enrollment IDI20171204001961
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 2

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 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.
53 services42 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.
17 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62901 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

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

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
1 supplier11 claims11 services$119.27 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier11 claims11 services$38.18 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

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

DR. ANAD K SALEM MD
Family Medicine
207 W JACKSON ST STE 201
CARBONDALE, IL 62901
Jackson County (618) 457-2963

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 Mallory Gauthier's NPI number?

The NPI number for Mallory Gauthier is 1598277907. It was assigned to this individual provider in the NPPES registry on October 26, 2017.

Where is Mallory Gauthier located?

Mallory Gauthier practices at 207 W Jackson St Ste 201, Carbondale, IL 62901. The listed phone number is (618) 457-2963.

What is Mallory Gauthier's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Mallory Gauthier enrolled in Medicare?

Yes. Mallory Gauthier is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mallory Gauthier was last updated on April 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.