1. Home
  2. Directory
  3. Kentucky
  4. Richmond
  5. Internal Medicine
  6. NPI Profile

JOHN PAUL GILLESPIE MD
NPI 1609984475
Internal Medicine in Richmond, KY

Active since August 29, 2006PECOS EnrolledAccepts Medicare Assignment
95.5/100
CMS Quality Rating
2013 MERCHANT DR STE 3, RICHMOND, KY 40475(859) 624-2290(859) 624-5455 Get Directions Write a Review

NPPES record last updated: September 1, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 1, 2023, Jun 15, 2023, Apr 6, 2023 and 1 more (4 updates tracked since 2023).

About John Paul Gillespie Md NPPES

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

JOHN PAUL GILLESPIE MD (NPI 1609984475) is an individual internal medicine provider in Richmond, Kentucky, licensed in Kentucky (23451) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Richmond, and is a graduate of University Of Kansas School Of Med (kc/wich/sal) (1980).

NPPES Registry Identity

NPI1609984475
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameJOHN PAUL GILLESPIECredential: MD
Location Address2013 MERCHANT DR STE 3Richmond, KY 40475-6856
Mailing Address2013 Merchant Dr Ste 3Richmond, KY 40475-6856 · (859) 624-2290 · Fax (859) 624-5455
Phone(859) 624-2290
Fax(859) 624-5455
Sole ProprietorNo
Medical School CMSUniversity Of Kansas School Of Med (kc/wich/sal)Graduated 1980
Enumeration DateAugust 29, 2006
Last NPPES UpdateSeptember 1, 20234 updates tracked since enumeration
NPPES CertifiedSeptember 1, 2023
✔ NPI 1609984475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in KY · 23451
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.
2013 MERCHANT DR STE 3, Richmond, KY 40475
Open in Google Maps ↗

Other Identifiers 2

Medicaid64234511KY
Other000000048340KY · Anthem

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.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

John Paul Gillespie 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 ID941264170
PECOS Enrollment IDI20090708000240
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.

Hospital Affiliations CMS Care Compare 2

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

Baptist Health Richmond

Acute Care Hospitals · Richmond, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180049
Location801 Eastern BypassRichmond, KY 40475 · Madison County
Emergency services Birthing friendly

Baptist Health Lexington

Acute Care Hospitals · Lexington, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number180103
Location1740 Nicholasville RoadLexington, KY 40503 · Fayette County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40475 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
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

95.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality89.59
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
84%450 patients4/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
52%142 patients3/55-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.
99%5,640 patients5/55-star benchmark: 99%
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%166 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.
98%913 patients5/55-star benchmark: 97%
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…
89%894 patients4/55-star benchmark: 97%
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…
86%913 patients4/55-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…
1%913 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
5%913 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 12

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
6 suppliers19 claims74 services$6.31 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
5 suppliers27 claims27 services$44.13 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
5 suppliers20 claims116 services$25.22 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
6 suppliers30 claims30 services$68.25 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
6 suppliers21 claims21 services$22.07 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
6 suppliers34 claims200 services$3.05 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.

ADVANCED PRIMARY & BEHAVIORAL HEALTH LLC
Clinic/Center (Rural Health)
2013 MERCHANT DR STE 3
RICHMOND, KY 40475
Madison County (859) 624-2290
HEATHER MCCLURE APRN
Nurse Practitioner (Family)
2013 MERCHANT DR STE 3
RICHMOND, KY 40475
Madison County (859) 624-2290

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 John Gillespie's NPI number?

The NPI number for John Gillespie is 1609984475. It was assigned to this individual provider in the NPPES registry on August 29, 2006.

Where is John Gillespie located?

John Gillespie practices at 2013 Merchant Dr Ste 3, Richmond, KY 40475. The listed phone number is (859) 624-2290.

What is John Gillespie's specialty?

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

Is John Gillespie enrolled in Medicare?

Yes. John Gillespie 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 John Gillespie accept?

Health plans from CareSource list John Gillespie 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 John Gillespie affiliated with any hospitals?

According to CMS data, John Gillespie is affiliated with Baptist Health Richmond and Baptist Health Lexington.

When was this NPI record last updated?

The NPPES record for John Gillespie was last updated on September 1, 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.