DR. TOM OAK JR. MCGUIRE (M.D.) – Obstetrics & Gynecology Physician, NPI 1205812435
Obstetrics & Gynecology Physician
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Profile Insights
NPPES metrics only — not quality of care.
631 OBSTETRICS/GYNECOLOGY in KY
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Provider Addresses for DR. TOM OAK JR. MCGUIRE (M.D.)
South Bypass Road, Pikeville, Pike County, Kentucky, 41501, United States
7TH FLOOR CLINIC
PIKEVILLE, KY 415011689
Phone: (606) 218-1000
Fax: (606) 218-7507
Type: Location
PO BOX 432
PIKEVILLE, KY 415020432
Phone: (606) 430-2207
Fax: (606) 218-7507
Type: Mailing
911 BYPASS RD BLDG A
PIKEVILLE, KY 415011689
Phone: (606) 430-2207
Fax: (606) 218-7507
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 25 Open Payments records for all available years, with a total value of $408.
Total Amount is formed as General ($408) + Research ($0) + Ownership ($0) = $408.
Last reported payment date: 2024-11-14 • Largest payer in this snapshot: Daiichi Sankyo Inc. ($52).
Total Amount
$408
General + Research + Ownership
Payments
25
Total payment records
General Amount
$408
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Daiichi Sankyo Inc. | $52 |
| Sage Therapeutics, Inc. | $50 |
| Exeltis, USA Inc. | $31 |
| Gynesonics, Inc. | $28 |
| Heron Therapeutics, Inc. | $22 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-09-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110901000456 | I | Obstetrics/Gynecology | KY | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | 23 | 23 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 20 | 14 | $0 |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | 11 | 11 | $0 |
Insurance plans in this area (ZIP 41501)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | KY | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY | |
| - | KY | |
| Hematology/Oncology, Internal Medicine | KY | |
| - | KY | |
| Physician Assistant | KY | |
| Critical Care (Intensivists) | OH | |
| Emergency Medicine | OH | |
| Certified Registered Nurse Anesthetist (Crna) | KY |
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