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PAUL KENNETH GAVINS PA-C
NPI 1952308272
Physician Assistant in Madison, WI

Active since July 01, 2005PECOS EnrolledAccepts Medicare Assignment
700 S PARK ST, MADISON, WI 53715(608) 260-2900(608) 260-3447 Get Directions Write a Review

NPPES record last updated: November 24, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Nov 24, 2020, Nov 17, 2020 (2 updates tracked since 2020).

About Paul Kenneth Gavins Pa-c NPPES

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

PAUL KENNETH GAVINS PA-C (NPI 1952308272) is an individual physician assistant in Madison, Wisconsin, licensed in Wisconsin (2328-023) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Ssm Health St Clare Hospital - Baraboo, and is a graduate of Other (1996).

NPPES Registry Identity

NPI1952308272
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NamePAUL KENNETH GAVINSCredential: PA-C
Location Address700 S PARK STMadison, WI 53715-1830
Mailing Address700 S Park StMadison, WI 53715-1830 · (608) 260-2900 · Fax (608) 260-3447
Phone(608) 260-2900
Fax(608) 260-3447
Sole ProprietorNo
Medical School CMSOtherGraduated 1996
Enumeration DateJuly 1, 2005
Last NPPES UpdateNovember 24, 20202 updates tracked since enumeration
NPPES CertifiedNovember 24, 2020
✔ NPI 1952308272 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in WI · 2328-023
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 2328-023 (WI)
Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License 2328-023 (WI)
700 S PARK ST, Madison, WI 53715
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Other Identifiers 1

Medicaid1952308272WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Paul Kenneth Gavins Pa-c 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 ID3476621855
PECOS Enrollment IDI20081013000315
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 3

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.
67 services56 patients
Insertion of cage or mesh device to spine bone and disc space during spine fusion 22853
Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.
23 services12 patients
Fusion of spine in lower back with partial removal of spine bone and disc 22633
This procedure, called lumbar spinal fusion, involves joining two or more vertebrae in your lower back. It includes a partial removal of a spine bone and disc to alleviate pain and improve stability. The goal is to reduce motion between vertebrae and prevent nerve irritation.
12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Ssm Health St Clare Hospital - Baraboo

Acute Care Hospitals · Baraboo, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520057
Location707 14th StBaraboo, WI 53913 · Sauk County
Emergency services Birthing friendly

Ssm Health St Mary's Hospital - Madison

Acute Care Hospitals · Madison, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520083
Location700 South Park StMadison, WI 53715 · Dane County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53715 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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.

Reported Quality Measures

Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
83%36 patients4/55-star benchmark: 100%
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…
35%37 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 20

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

CHRISTOPHER DO
Physician Assistant
700 S PARK ST
MADISON, WI 53715
Dane County (608) 251-6100
JEREMI THOMAS OLSON PA-C
Physician Assistant (Surgical)
700 S PARK ST, DEAN ST. MARY'S OUTPATIENT CENTER
MADISON, WI 53715
Dane County (608) 260-2900
TIMOTHY J MORTON PA-C
Physician Assistant
700 S PARK ST, DEAN MEDICAL CENTER
MADISON, WI 53715
Dane County (608) 251-6100
STEPHEN H VANDER SLUIS
Anesthesiology
700 S PARK ST
MADISON, WI 53715
Dane County (608) 251-6100
BENJAMIN KLEIBER M.D.
Internal Medicine (Cardiovascular Disease)
700 S PARK ST, DEAN & ST. MARY'S OUTPATIENT CENTER
MADISON, WI 53715
Dane County (608) 260-2900
ERIN M MULLAN-TOWNS PA-C
Physician Assistant
700 S PARK ST
MADISON, WI 53715
Dane County (608) 260-2900
CONNIE SUE MCCULLICK APNP
Nurse Practitioner
700 S PARK ST
MADISON, WI 53715
Dane County (608) 251-6100
JUSTIN ALLEN LEHRKE CRNA
Nurse Anesthetist, Certified Registered
700 S PARK ST
MADISON, WI 53715
Dane County (608) 251-6100

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 Paul Gavins's NPI number?

The NPI number for Paul Gavins is 1952308272. It was assigned to this individual provider in the NPPES registry on July 1, 2005.

Where is Paul Gavins located?

Paul Gavins practices at 700 S Park St, Madison, WI 53715. The listed phone number is (608) 260-2900.

What is Paul Gavins's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Paul Gavins enrolled in Medicare?

Yes. Paul Gavins 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 Paul Gavins accept?

Health plans from Anthem Blue Cross and Blue Shield list Paul Gavins 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 Paul Gavins affiliated with any hospitals?

According to CMS data, Paul Gavins is affiliated with Ssm Health St Clare Hospital - Baraboo and Ssm Health St Mary's Hospital - Madison.

When was this NPI record last updated?

The NPPES record for Paul Gavins was last updated on November 24, 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.