CMS-1500 Box 24J / 33a • NPI
1972695633
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
208D00000X (CMS 01)
Licensed & Credentialed Allopathic & Osteopathic Physicians — General Practice
Box 32 Service Location & ZIP+4
240 SAUNDERS RD, RIVERWOODS, IL, 60015-3835
✓ 9-Digit EDI 837 ZIP+4 (60015-3835)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1972695633 (JERRY P GORE, M.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1972695633)
Medicare Beneficiaries
56
Total Billed Services
573
Distinct CPT/HCPCS Codes
8
Medicare Allowed Total
$81,428.26
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
90837 | Psychotherapy, 1 hour | 364 |
99205 | New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more | 24 |
99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 21 |
99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 128 |
99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | 27 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Olanzapine Olanzapine | 13 | <11 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1972695633 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | JERRY P GORE, M.D. |
| Plain-English Specialty | Licensed & Credentialed Allopathic & Osteopathic Physicians — General Practice NUCC Code: 208D00000X (General Practice) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 240 SAUNDERS RD, RIVERWOODS, IL, 60015-3835 |
| Practice Telephone / Fax | Tel: (847) 236-1701 | Fax: (847) 236-1705 |
| Administrative Mailing Address | 240 SAUNDERS RD, RIVERWOODS, IL, 60015-3835 |
| Enumeration & Last Sync | Enumerated: 2006-09-29 | CMS Record Updated: 2007-12-28 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (208D00000X)
What Does Taxonomy Code 208D00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208D00000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — General Practice"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (JERRY P GORE, M.D.)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
2084P0800X — Psychiatry & Neurology, PsychiatryPlain English: Board-Certified Psychiatrist (Mental Health & Behavioral Medicine Physician) | State: IL | License: 036053622 | Primary: Secondary |
208D00000X — General PracticePlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — General Practice | State: IL | License: 036053622 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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