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JOSEPH M MCGINLEY DO
NPI 1861518706
Family Medicine in Lehighton, PA

Active since March 22, 2007PECOS EnrolledAccepts Medicare Assignment
95.64/100
CMS Quality Rating
856 INTERCHANGE RD, LEHIGHTON, PA 18235(610) 377-9020 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Joseph M Mcginley Do NPPES

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

JOSEPH M MCGINLEY DO (NPI 1861518706) is an individual family medicine provider in Lehighton, Pennsylvania, licensed in Pennsylvania (OS012837) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS, is affiliated with St Luke's Hospital Bethlehem, and is a graduate of Philadelphia College Of Osteopathic Medicine (2002).

NPPES Registry Identity

NPI1861518706
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJOSEPH M MCGINLEYCredential: DO
Location Address856 INTERCHANGE RDLehighton, PA 18235-9286
Mailing Address856 Interchange RdLehighton, PA 18235-9286 · (610) 377-9020
Phone(610) 377-9020
Sole ProprietorNo
Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 2002
Enumeration DateMarch 22, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1861518706 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in PA · OS012837
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.
856 INTERCHANGE RD, Lehighton, PA 18235
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Other Identifiers 1

Medicare UPINI40382

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

Joseph M Mcginley Do 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 ID2365475407
PECOS Enrollment IDI20050919000101
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 11

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 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.
257 services173 patients
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.
240 services165 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
126 services126 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
45 services45 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
44 services44 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.
28 services24 patients

Hospital Affiliations CMS Care Compare 5

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

St Luke's Hospital Bethlehem

Acute Care Hospitals · Bethlehem, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390049
Location801 Ostrum StreetBethlehem, PA 18015 · Northampton County
Emergency services Birthing friendly

Lehigh Valley Hospital

Acute Care Hospitals · Allentown, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390133
Location1200 South Cedar Crest BoulevardAllentown, PA 18103 · Lehigh County
Emergency services Birthing friendly

St Luke's Miners Memorial Hospital

Acute Care Hospitals · Coaldale, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390183
Location360 W Ruddle StreetCoaldale, PA 18218 · Schuylkill County
Emergency services

St Luke's Hospital - Monroe Campus

Acute Care Hospitals · Stroudsburg, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390330
Location100 St Luke's LaneStroudsburg, PA 18360 · Monroe County
Emergency services

St Luke's Hospital - Carbon Campus

Acute Care Hospitals · Lehighton, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390335
Location500 St Luke's DriveLehighton, PA 18235 · Carbon County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18235 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

95.64/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.57
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 5

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 suppliers56 claims118 services$5.96 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
6 suppliers30 claims35 services$1.05 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
2 suppliers13 claims3,622 services$0.03 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 suppliers15 claims15 services$184.80 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
4 suppliers16 claims16 services$22.80 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 JOSEPH MCGINLEY PC
Family Medicine
856 INTERCHANGE RD
LEHIGHTON, PA 18235
Carbon County (610) 377-9020

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 Joseph Mcginley's NPI number?

The NPI number for Joseph Mcginley is 1861518706. It was assigned to this individual provider in the NPPES registry on March 22, 2007.

Where is Joseph Mcginley located?

Joseph Mcginley practices at 856 Interchange Rd, Lehighton, PA 18235. The listed phone number is (610) 377-9020.

What is Joseph Mcginley's specialty?

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

Is Joseph Mcginley enrolled in Medicare?

Yes. Joseph Mcginley 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.

Is Joseph Mcginley affiliated with any hospitals?

According to CMS data, Joseph Mcginley is affiliated with St Luke's Hospital Bethlehem, Lehigh Valley Hospital, St Luke's Miners Memorial Hospital, St Luke's Hospital - Monroe Campus and St Luke's Hospital - Carbon Campus.

When was this NPI record last updated?

The NPPES record for Joseph Mcginley was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.