Individual provider Active NPI

Raul J Gagucas, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Gallipolis, OH
National Provider Identifier
1144273053
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
35-07-2887 Issued in OH
Practice address
100 Jackson Pike
Gallipolis, OH 45631-1560
Phone
(740) 446-5148
Fax
(740) 446-5488
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 17773 WV
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 35-07-2887 OH Primary

Addresses

Primary practice location

100 Jackson Pike
Gallipolis, OH 45631-1560

Mailing address

90 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 446-5148

Other identifiers 7

IdentifierTypeStateIssuer
000000007412OtherANTHEM BCBS
000000191258OtherOHUNISON MEDICAID
2031376OtherOHMOLINA MEDICAID
2031376MedicaidOH
310917085139OtherOHCARESOURCE MEDICAID
220020393OtherRR MEDICARE
0102973000MedicaidWV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address raul.gagucas.1@17389.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, WV2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041111000092 OH Practitioner - Pathology 0840253712 Reassigns benefits to 1 organization
I20041111000124 WV Practitioner - Pathology 0840253712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holzer Clinic LLCGroup PAC ID 5890606008, 266 clinicians

Practice addresses (Care Compare)

100 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 446-5050

2605 Jackson Ave
Point Pleasant, WV 25550-1615
Phone (304) 675-4498

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.27 of 100Reported as group
Quality
68.56
Promoting interoperability
100
Improvement activities
40
Cost
68.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Holzer Clinic, LLC CurrentSince Aug 25, 1997 Accepting new patients
I Path LLC Anatomic Pathology & Clinical Pathology Current Accepting new patients

Locations

100 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5050

90 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5131

500 Burlington Rd
Jackson, OH 45640
Phone (740) 288-4625

2605 Jackson Ave
Pt Pleasant, WV 25550
Phone (304) 675-4498

313 Maccorkle Ave SW
South Charleston, WV 25303
Phone (304) 744-2300

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1144273053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-446-5148",
            "fax_number": "740-446-5488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-446-5148",
            "fax_number": "740-446-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGUCAS",
        "first_name": "RAUL",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WV",
            "license": "17773",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OH",
            "license": "35-07-2887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000007412",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON MEDICAID",
            "identifier": "000000191258",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA MEDICAID",
            "identifier": "2031376",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2031376",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE MEDICAID",
            "identifier": "310917085139",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "220020393",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0102973000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "raul.gagucas.1@17389.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "100 Jackson Pike",
            "city": "Gallipolis",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456311560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gallipolis, OH

Sources for this page

Verify at the official NPI Registry.