MARK P GILLIGAN MD
NPI 1811922917
Orthopaedic Surgery in Burlington, MA

Active since July 11, 2006PECOS EnrolledAccepts Medicare Assignment
91.41/100
CMS Quality Rating
41 MALL ROAD, BURLINGTON, MA 01805(781) 744-8650(781) 744-5345 Get Directions Write a Review

NPPES record last updated: December 19, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mark P Gilligan Md NPPES

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

MARK P GILLIGAN MD (NPI 1811922917) is an individual orthopaedic surgery provider in Burlington, Massachusetts, licensed in Massachusetts (81757) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Northeast Hospital Corporation, and is a graduate of Warren Alpert Medical School Of Brown University (1989).

NPPES Registry Identity

NPI1811922917
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameMARK P GILLIGANCredential: MD
Location Address41 MALL ROADBurlington, MA 01805-0001
Mailing Address41 Mall RoadBurlington, MA 01805-0001 · (781) 744-8650 · Fax (781) 744-5345
Fax(781) 744-5345
Sole ProprietorNo
Medical School CMSWarren Alpert Medical School Of Brown UniversityGraduated 1989
Enumeration DateJuly 11, 2006
Last NPPES UpdateDecember 19, 2017
NPI 1811922917 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License Licensed in MA · 81757
Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

41 MALL ROAD, Burlington, MA 01805

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

Mark P Gilligan 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 ID5698739456
PECOS Enrollment IDI20041201000901
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 5

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, 20-29 minutes 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.
538 services346 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.
312 services207 patients
New patient office or other outpatient visit, 30-44 minutes 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
252 services252 patients
Established patient office or other outpatient visit, 30-39 minutes 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.
51 services50 patients
New patient office or other outpatient visit, 45-59 minutes 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.
32 services32 patients

Hospital Affiliations CMS Care Compare 3

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

Northeast Hospital Corporation

Acute Care Hospitals · Beverly, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220033
Location85 Herrick StreetBeverly, MA 01915 · Essex County
Emergency services Birthing friendly

Winchester Hospital

Acute Care Hospitals · Winchester, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220105
Location41 Highland AvenueWinchester, MA 01890 · Middlesex County
Emergency services Birthing friendly

Lahey Hospital & Medical Center, Burlington

Acute Care Hospitals · Burlington, MA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220171
Location41 & 45 Mall RoadBurlington, MA 01803 · Middlesex County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01805 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
$97.64 typical visit price
range $63.72 – $189.86
Typical copayment $24.41 (range $15.93 – $47.46)
Most-billed visit code 99203
Established Patient
$78.84 typical visit price
range $21.07 – $155.29
Typical copayment $19.71 (range $5.26 – $38.82)
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.

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.

91.41/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality76.87
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 3

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

Knee orthosis, elastic with joints, prefabricated, off-the-shelf L1812
DME-Orthotic Devices · category DF011N
1 supplier18 claims18 services$63.49 avg. paid by Medicare
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf L1902
DME-Orthotic Devices · category DF003N
1 supplier12 claims12 services$71.78 avg. paid by Medicare
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf L4361
DME-Orthotic Devices · category DF003N
1 supplier13 claims13 services$241.58 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 19

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

Physician Assistant
41 MALL ROAD, LAHEY CLINIC
BURLINGTON, MA 01805
Radiology (Diagnostic Radiology)
41 MALL ROAD
BURLINGTON, MA 01805
Nurse Practitioner
41 MALL ROAD
BURLINGTON, MA 01805
Optometrist
41 MALL ROAD, LAHEY CLINIC
BURLINGTON, MA 01805
Hospitalist
41 MALL ROAD, LAHEY CLINIC
BURLINGTON, MA 01805
Nurse Practitioner (Adult Health)
41 MALL ROAD, LAHEY CLINIC, INC.
BURLINGTON, MA 01805
Internal Medicine (Cardiovascular Disease)
41 MALL ROAD, LAHEY CLINIC, INC.
BURLINGTON, MA 01805
Physician Assistant
41 MALL ROAD, LAHEY HOSPITAL AND MEDICAL CENTER
BURLINGTON, MA 01805

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 Mark Gilligan's NPI number?

The NPI number for Mark Gilligan is 1811922917. It was assigned to this individual provider in the NPPES registry on July 11, 2006.

Where is Mark Gilligan located?

Mark Gilligan practices at 41 Mall Road, Burlington, MA 01805. The listed phone number is (781) 744-8650.

What is Mark Gilligan's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Mark Gilligan enrolled in Medicare?

Yes. Mark Gilligan 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 Mark Gilligan accept?

Health plans from Anthem Blue Cross and Blue Sheld and Anthem Blue Cross and Blue Shield list Mark Gilligan 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 Mark Gilligan affiliated with any hospitals?

According to CMS data, Mark Gilligan is affiliated with Northeast Hospital Corporation, Winchester Hospital and Lahey Hospital & Medical Center, Burlington.

When was this NPI record last updated?

The NPPES record for Mark Gilligan was last updated on December 19, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.