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GILBERT E MARCHAL M.D.
NPI 1861493074
Family Medicine in Louisville, KY

Active since August 10, 2005PECOS EnrolledAccepts Medicare Assignment
73.19/100
CMS Quality Rating
5129 DIXIE HWY, SUITE 100, LOUISVILLE, KY 40216(502) 447-3242(502) 448-4722 Get Directions Write a Review

NPPES record last updated: March 20, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 20, 2018, Nov 15, 2016 (2 updates tracked since 2016).

About Gilbert E Marchal M.d. NPPES

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

GILBERT E MARCHAL M.D. (NPI 1861493074) is an individual family medicine provider in Louisville, Kentucky, licensed in Kentucky (19173) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Jewish Hospital & St Mary's Healthcare, and is a graduate of University Of Louisville School Of Medicine (1976).

NPPES Registry Identity

NPI1861493074
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameGILBERT E MARCHALCredential: M.D.
Location Address5129 DIXIE HWY, SUITE 100Louisville, KY 40216-1727
Mailing Address100 E Liberty St, Suite 800Louisville, KY 40202-1434 · (502) 447-3242 · Fax (502) 448-4722
Phone(502) 447-3242
Fax(502) 448-4722
Sole ProprietorNo
Medical School CMSUniversity Of Louisville School Of MedicineGraduated 1976
Enumeration DateAugust 10, 2005
Last NPPES UpdateMarch 20, 20182 updates tracked since enumeration
✔ NPI 1861493074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in KY · 19173
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
5129 DIXIE HWY, Louisville, KY 40216
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Other Identifiers 1

Medicaid64191737KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.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

Gilbert E Marchal M.d. 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 ID4981622321
PECOS Enrollment IDI20060126000530
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 10

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.
246 services181 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.
220 services173 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
143 services127 patients
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702
This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.
141 services44 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
101 services52 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
91 services65 patients

Hospital Affiliations CMS Care Compare 3

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

Jewish Hospital & St Mary's Healthcare

Acute Care Hospitals · Louisville, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180040
Location200 Abraham Flexner WayLouisville, KY 40202 · Jefferson County
Emergency services

Norton Hospitals, Inc

Acute Care Hospitals · Louisville, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180088
Location200 East Chestnut StreetLouisville, KY 40202 · Jefferson County
Emergency services Birthing friendly

Baptist Health Louisville

Acute Care Hospitals · Louisville, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180130
Location4000 Kresge WayLouisville, KY 40207 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40216 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
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.

73.19/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality58.74
Promoting Interoperability100
Improvement Activities40
Cost51.91

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.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
9 suppliers26 claims48 services$5.94 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers16 claims16 services$20.71 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
2 suppliers20 claims20 services$175.64 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 15

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

ASSOCIATES IN GENERAL SURGERY,PSC
Surgery
5129 DIXIE HWY, 205
LOUISVILLE, KY 40216
Jefferson County (502) 583-5948
DR. BRUCE HUNT MD
Family Medicine
5129 DIXIE HWY, SUITE 100
LOUISVILLE, KY 40216
Jefferson County (502) 447-3242
DR. MATTHEW S CLOWER MD
Radiology (Diagnostic Radiology)
5129 DIXIE HWY, SUITE 100
LOUISVILLE, KY 40216
Jefferson County (502) 447-8786
JEFFERSON HEALTH AND WELLNESS
Chiropractor
5129 DIXIE HWY, SUITE 301
LOUISVILLE, KY 40216
Jefferson County (502) 448-2056
UNIVERSITY OF LOUISVILLE PHYISICIANS, INC.
Pain Medicine (Interventional Pain Medicine)
5129 DIXIE HWY
LOUISVILLE, KY 40216
Jefferson County (502) 588-6000
JOHN O FAUREST M.D.
Family Medicine
5129 DIXIE HWY
LOUISVILLE, KY 40216
Jefferson County (502) 447-3242
W NORRIS JENNINGS M.D.
Family Medicine
5129 DIXIE HWY
LOUISVILLE, KY 40216
Jefferson County (502) 447-3242
MRS. ANGELIA MARIE JACKSON APRN, FNP-C
Nurse Practitioner (Family)
5129 DIXIE HWY
LOUISVILLE, KY 40216
Jefferson County (502) 447-3242

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 Gilbert Marchal's NPI number?

The NPI number for Gilbert Marchal is 1861493074. It was assigned to this individual provider in the NPPES registry on August 10, 2005.

Where is Gilbert Marchal located?

Gilbert Marchal practices at 5129 Dixie Hwy Suite 100, Louisville, KY 40216. The listed phone number is (502) 447-3242.

What is Gilbert Marchal's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Gilbert Marchal enrolled in Medicare?

Yes. Gilbert Marchal 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 Gilbert Marchal accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and CareSource list Gilbert Marchal 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 Gilbert Marchal affiliated with any hospitals?

According to CMS data, Gilbert Marchal is affiliated with Jewish Hospital & St Mary's Healthcare, Norton Hospitals, Inc and Baptist Health Louisville.

When was this NPI record last updated?

The NPPES record for Gilbert Marchal was last updated on March 20, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.