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GERALD M MACHEN M.D.
NPI 1881676930
Family Medicine in Cullman, AL

Active since November 15, 2005PECOS EnrolledAccepts Medicare Assignment
1800 AL HIGHWAY 157, CULLMAN, AL 35058(256) 735-5075(256) 735-5076 Get Directions Write a Review

NPPES record last updated: December 31, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 31, 2025, Dec 22, 2020, Mar 27, 2018 (3 updates tracked since 2018).

About Gerald M Machen M.d. NPPES

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

GERALD M MACHEN M.D. (NPI 1881676930) is an individual family medicine provider in Cullman, Alabama, licensed in Alabama (11516) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS and is a graduate of University Of Alabama School Of Medicine (1983).

NPPES Registry Identity

NPI1881676930
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameGERALD M MACHENCredential: M.D.
Location Address1800 AL HIGHWAY 157Cullman, AL 35058-1271
Mailing AddressPo Box 2895Cullman, AL 35056-2895 · (256) 735-5044 · Fax (256) 801-7626
Phone(256) 735-5075
Fax(256) 735-5076
Sole ProprietorNo
Medical School CMSUniversity Of Alabama School Of MedicineGraduated 1983
Enumeration DateNovember 15, 2005
Last NPPES UpdateDecember 31, 20253 updates tracked since enumeration
NPPES CertifiedDecember 31, 2025
✔ NPI 1881676930 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in AL · 11516
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.
1800 AL HIGHWAY 157, Cullman, AL 35058
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Magnolia Health, Ambetter Health, Ambetter of Alabama 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

Gerald M Machen 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 ID5698799682
PECOS Enrollment IDI20101122001113
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 7

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.
317 services95 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.
150 services63 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
62 services51 patients
Injection, ceftriaxone sodium, per 250 mg J0696
Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.
52 services11 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.
49 services17 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.
29 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35058 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
$81.90 typical visit price
range $52.65 – $161.63
Typical copayment $20.47 (range $13.16 – $40.40)
Most-billed visit code 99203
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
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.

Reported Quality Measures

Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
47%198 patients
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
67%308 patients3/55-star benchmark: 90%
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…
84%957 patients4/55-star benchmark: 97%
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 7

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
7 suppliers18 claims45 services$6.16 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers24 claims24 services$17.00 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
1 supplier12 claims12 services$784.18 avg. paid by Medicare
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
2 suppliers15 claims15 services$73.77 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
4 suppliers15 claims2,412 services$0.04 avg. paid by Medicare
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626
DME-Drugs Administered Through DME · category DG000N
1 supplier12 claims360 services$0.82 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.

DEBRA W MORRISON RDN
Dietitian, Registered
1800 AL HIGHWAY 157
CULLMAN, AL 35058
Cullman County (256) 739-4131
JOHN R GOBER M.D.
Family Medicine
1800 AL HIGHWAY 157, SUITE 101
CULLMAN, AL 35058
Cullman County (256) 739-4131
TAMMY CORNELIUS CRNP
Nurse Practitioner (Primary Care)
1800 AL HIGHWAY 157, SUITE 101
CULLMAN, AL 35058
Cullman County (256) 734-1012
KARA LYN MOORE CRNP
Nurse Practitioner (Neonatal, Critical Care)
1800 AL HIGHWAY 157
CULLMAN, AL 35058
Cullman County (256) 735-5075
BETHANY BLANTON LAMAR CRNP
Nurse Practitioner (Family)
1800 AL HIGHWAY 157
CULLMAN, AL 35058
Cullman County (256) 735-5075
JOHN R MORGAN M.D.
Family Medicine
1800 AL HIGHWAY 157
CULLMAN, AL 35058
Cullman County (256) 735-5075
CHRISTOPHER H DODD M.D.
Pediatrics
1800 AL HIGHWAY 157
CULLMAN, AL 35058
Cullman County (256) 735-5075
DR. CARLOS VILLAR-GOSALVEZ M.D.
Family Medicine
1800 AL HIGHWAY 157
CULLMAN, AL 35058
Cullman County (256) 735-5075

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 Gerald Machen's NPI number?

The NPI number for Gerald Machen is 1881676930. It was assigned to this individual provider in the NPPES registry on November 15, 2005.

Where is Gerald Machen located?

Gerald Machen practices at 1800 Al Highway 157, Cullman, AL 35058. The listed phone number is (256) 735-5075.

What is Gerald Machen's specialty?

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

Is Gerald Machen enrolled in Medicare?

Yes. Gerald Machen 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 Gerald Machen accept?

Health plans from Ambetter Health, Ambetter from Magnolia Health, Ambetter of Alabama, Ambetter of Tennessee and Blue Cross and Blue Shield of Alabama and 1 other insurer list Gerald Machen 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.

When was this NPI record last updated?

The NPPES record for Gerald Machen was last updated on December 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.