DR. JOHN FRANKLIN GILMORE MD
NPI 1922180496
Family Medicine in Tomball, TX

Q: What is John Gilmore's NPI number?

The NPI number for John Gilmore is 1922180496. It was assigned to this individual provider in the NPPES registry on October 20, 2006.

Q: What is John Gilmore's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for John Gilmore was last updated on October 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since October 20, 2006PECOS EnrolledAccepts Medicare Assignment

81.97/100

CMS Quality Rating

425 HOLDERRIETH BLVD, SUITE 212, TOMBALL, TX 77375(346) 246-3424(832) 761-7699 Get Directions Write a Review

NPPES record last updated: October 6, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. John Franklin Gilmore Md NPPES

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

DR. JOHN FRANKLIN GILMORE MD (NPI 1922180496) is an individual family medicine provider in Tomball, Texas, licensed in Texas (K0474) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS and is a graduate of Texas Tech University Health Science Center School Of Medicine (1995).

NPPES Registry Identity

NPI1922180496

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. JOHN FRANKLIN GILMORECredential: MD

Location Address425 HOLDERRIETH BLVD, SUITE 212Tomball, TX 77375

Mailing Address425 Holderrieth Blvd, Suite 212Tomball, TX 77375 · (346) 246-3424 · Fax (832) 761-7699

Phone(346) 246-3424

Fax(832) 761-7699

Sole ProprietorNo

Medical School CMSTexas Tech University Health Science Center School Of MedicineGraduated 1995

Enumeration DateOctober 20, 2006

Last NPPES UpdateOctober 6, 2020

NPPES CertifiedOctober 6, 2020

✔ NPI 1922180496 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in TX · K0474

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.

425 HOLDERRIETH BLVD, Tomball, TX 77375

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Molina Healthcare, Oscar Insurance Company 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

Dr. John Franklin Gilmore 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 ID1951397173

PECOS Enrollment IDI20040423000969

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 17

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.

1,273 services436 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.

466 services267 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.

256 services256 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

247 services247 patients

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.

217 services44 patients

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

205 services43 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

160 services157 patients

Testing for presence of drug, read by direct observation 80305

Testing for the presence of drugs involves collecting a sample, usually urine, which is then analyzed for specific substances. The process is monitored directly to ensure accuracy and integrity. This test helps to confirm if drugs are present in your system.

112 services63 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.

75 services60 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

69 services45 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

45 services37 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 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.

29 services29 patients

Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a G0179

This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.

20 services11 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

20 services20 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

16 services13 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.

14 services14 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77375 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

$90.40 typical visit price

range $58.24 – $176.98

Typical copayment $22.60 (range $14.56 – $44.24)

Most-billed visit code 99203

Established Patient

$102.71 typical visit price

range $18.60 – $143.93

Typical copayment $25.67 (range $4.65 – $35.98)

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.

81.97/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

84.8

Improvement Activities

Cost

60.16

Reported Quality Measures

Adult Major Depressive Disorder (MDD): Suicide Risk Assessment

0%247 patients

Breast Cancer Screening

51%1,081 patients3/55-star benchmark: 93%

Cervical Cancer Screening

40%1,582 patients2/55-star benchmark: 98%

Closing the Referral Loop: Receipt of Specialist Report

13%439 patients1/55-star benchmark: 87%

Colorectal Cancer Screening

21%2,580 patients1/55-star benchmark: 88%

Controlling High Blood Pressure

74%1,461 patients4/55-star benchmark: 91%

Diabetes: Eye Exam

11%668 patients1/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

19%668 patients4/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

95%16,933 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

57%1,183 patients3/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

23%4,386 patients1/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

39%3,830 patients2/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 87% · 3,823 patients

Patients screened: 97% · 3,823 patients

11%464 patients1/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

78%1,119 patients4/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 3% · 1,194 patients

Patients totalRate: 19% · 1,286 patients

20%1,286 patients2/55-star benchmark: 100%

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.

Other Providers at the Same Location NPPES 14

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

TOMBALL FOOT AND ANKLE CENTER PC

Podiatrist (Foot & Ankle Surgery)

425 HOLDERRIETH BLVD, 100
TOMBALL, TX 77375

Harris County (281) 351-8866

MR. RICHARD STERLING BROWN MD

Surgery

425 HOLDERRIETH BLVD, #101
TOMBALL, TX 77375

Harris County (281) 351-8278

EAST SIDE SLEEP CENTER, LLC

Clinic/Center (Sleep Disorder Diagnostic)

425 HOLDERRIETH BLVD, 210
TOMBALL, TX 77375

Harris County (281) 207-8889

NORTHWEST GASTROENTEROLOGY ASSOCIATES P.A.

Internal Medicine (Gastroenterology)

425 HOLDERRIETH BLVD, STE. 109
TOMBALL, TX 77375

Harris County (281) 357-8882

DR. BARBARA D MARINO MD FACOG

Obstetrics & Gynecology (Gynecology)

425 HOLDERRIETH BLVD, SUITE 212
TOMBALL, TX 77375

Harris County (281) 364-6614

MS. SUZANNA TENNYSON PAXTON LCSW, LCDC, LMT

Social Worker (Clinical)

425 HOLDERRIETH BLVD, SUITE 201A
TOMBALL, TX 77375

Harris County (713) 702-4834

SERIES A - A SERIES OF PRAXIS HEALTHCARE HOLDINGS SERIES LLC

Clinic/Center (Primary Care)

425 HOLDERRIETH BLVD
TOMBALL, TX 77375

Harris County (281) 357-8885

INDIAN PARTNERS

Surgery

425 HOLDERRIETH BLVD, SUITE 207
TOMBALL, TX 77375

Harris County (281) 290-6300

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 John Gilmore's NPI number?

The NPI number for John Gilmore is 1922180496. It was assigned to this individual provider in the NPPES registry on October 20, 2006.

Where is John Gilmore located?

John Gilmore practices at 425 Holderrieth Blvd Suite 212, Tomball, TX 77375. The listed phone number is (346) 246-3424.

What is John Gilmore's specialty?

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

Is John Gilmore enrolled in Medicare?

Yes. John Gilmore 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 John Gilmore accept?

Health plans from Blue Cross and Blue Shield of Texas, Molina Healthcare, Oscar Insurance Company and UnitedHealthcare list John Gilmore 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 John Gilmore was last updated on October 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.