DR. MICHAEL ANDREW GAINER M.D.
NPI 1922068303
Orthopaedic Surgery - Hand Surgery in Springfield, IL

Active since March 28, 2006PECOS EnrolledAccepts Medicare Assignment
97.58/100
CMS Quality Rating
1301 S KOKE MILL RD, SPRINGFIELD, IL 62711(217) 547-9230(217) 547-9236 Get Directions Write a Review

NPPES record last updated: August 6, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 6, 2025, Jun 25, 2025 (2 updates tracked since 2025).

About Dr. Michael Andrew Gainer M.d. NPPES

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

DR. MICHAEL ANDREW GAINER M.D. (NPI 1922068303) is an individual hand surgery provider in Springfield, Illinois, licensed in Illinois (036.103413) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with St Johns Hospital, and is a graduate of Southern Illinois University School Of Medicine (1995).

NPPES Registry Identity

NPI1922068303
Entity TypeIndividualMale
Primary Taxonomy207XS0106X
Provider Legal NameDR. MICHAEL ANDREW GAINERCredential: M.D.
Location Address1301 S KOKE MILL RDSpringfield, IL 62711-9252
Mailing Address1301 S Koke Mill RdSpringfield, IL 62711-9252 · (217) 547-9100 · Fax (217) 547-9236
Fax(217) 547-9236
Sole ProprietorNo
Medical School CMSSouthern Illinois University School Of MedicineGraduated 1995
Enumeration DateMarch 28, 2006
Last NPPES UpdateAugust 6, 20252 updates tracked since enumeration
NPPES CertifiedAugust 6, 2025
NPI 1922068303 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOrthopaedic Surgery · Hand SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207XS0106X
License Licensed in IL · 036.103413
Definition
An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.
1301 S KOKE MILL RD, Springfield, IL 62711

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

Dr. Michael Andrew Gainer 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 ID2769463132
PECOS Enrollment IDI20250703002891
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 15

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
358 services57 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.
142 services119 patients
X-ray of wrist, minimum of 3 views 73110
An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.
74 services44 patients
Injection into tendon or ligament 20550
An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.
56 services45 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 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.
52 services52 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.
45 services42 patients

Hospital Affiliations CMS Care Compare 3

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

St Johns Hospital

Acute Care Hospitals · Springfield, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140053
Location800 E Carpenter StSpringfield, IL 62769 · Sangamon County
Emergency services Birthing friendly

Decatur Memorial Hospital

Acute Care Hospitals · Decatur, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number140135
Location2300 North Edward StreetDecatur, IL 62526 · Macon County
Emergency services Birthing friendly

Memorial Medical Center

Acute Care Hospitals · Springfield, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140148
Location701 N First StSpringfield, IL 62702 · Sangamon County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62711 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
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.

97.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.53
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims

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

Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf L3908
DME-Orthotic Devices · category DF000N
4 suppliers12 claims13 services$43.86 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 20

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

Neurological Surgery
1301 S KOKE MILL RD
SPRINGFIELD, IL 62711
Physical Medicine & Rehabilitation (Pain Medicine)
1301 S KOKE MILL RD
SPRINGFIELD, IL 62711
Physical Therapist
1301 S KOKE MILL RD
SPRINGFIELD, IL 62711
Neurological Surgery
1301 S KOKE MILL RD
SPRINGFIELD, IL 62711
Physical Therapist
1301 S KOKE MILL RD
SPRINGFIELD, IL 62711
Occupational Therapist
1301 S KOKE MILL RD
SPRINGFIELD, IL 62711
Podiatrist (Foot & Ankle Surgery)
1301 S KOKE MILL RD
SPRINGFIELD, IL 62711
Registered Nurse (Registered Nurse First Assistant)
1301 S KOKE MILL RD
SPRINGFIELD, IL 62711

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 Michael Gainer's NPI number?

The NPI number for Michael Gainer is 1922068303. It was assigned to this individual provider in the NPPES registry on March 28, 2006.

Where is Michael Gainer located?

Michael Gainer practices at 1301 S Koke Mill Rd, Springfield, IL 62711. The listed phone number is (217) 547-9230.

What is Michael Gainer's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Hand Surgery, with taxonomy code 207XS0106X.

Is Michael Gainer enrolled in Medicare?

Yes. Michael Gainer 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 Michael Gainer accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 2 other insurers list Michael Gainer 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 Michael Gainer affiliated with any hospitals?

According to CMS data, Michael Gainer is affiliated with St Johns Hospital, Decatur Memorial Hospital and Memorial Medical Center.

When was this NPI record last updated?

The NPPES record for Michael Gainer was last updated on August 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.