DR. MICHAEL LAWRENCE MAGGUILLI MD
NPI 1194082925
Pathology - Cytopathology in Oklahoma City, OK
Quality Rating: 76.47 out of 100 score
NPI Status: Active since April 18, 2012
Contact Information
940 STANTON L YOUNG BLVD # 451
OKLAHOMA CITY, OK
ZIP 73104
Phone: (405) 271-1515
Fax: (405) 271-1001
- NPI Profile Information
- Primary Taxonomy
- Secondary Taxonomies
- Insurance Plans Accepted
- Medicare Participation & PECOS Status
- Areas of Expertise
- Physician Visit Costs
- Overall Quality Performance
- Hospital Affiliations - Privileges
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
- Individual
- Male
- Years of Experience 14
- Pathology
- Cytopathology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About MICHAEL MAGGUILLI
This page provides the complete NPI Profile along with additional information for Michael Magguilli, a provider established in Oklahoma City, Oklahoma with a medical specialization in Pathology, focusing in cytopathology and more than 14 years of experience. The healthcare provider is registered in the NPI registry with number 1194082925 assigned on April 2012. The practitioner's primary taxonomy code is 207ZC0500X with license number 276817 (NY). The provider is registered as an individual and his NPI record was last updated 7 years ago.
- NPI
- 1194082925
- Provider Name
- DR. MICHAEL LAWRENCE MAGGUILLI MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 940 STANTON L YOUNG BLVD # 451 OKLAHOMA CITY, OK 73104
- Location Phone
- (405) 271-1515
- Location Fax
- (405) 271-1001
- Mailing Address
- 1122 NE 13TH ST # ORI236 OKLAHOMA CITY, OK 73117
- Mailing Phone
- (405) 271-1515
- Mailing Fax
- (405) 271-1001
- Medical School Name
- OTHER
- Graduation Year
- 2012
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-18-2012
- Last Update Date
- 03-28-2018
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pathology Cytopathology
- Taxonomy Code
- 207ZC0500X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 276817
- License State
- NY
- Taxonomy Description
- A cytopathologist is an anatomic pathologist trained in the diagnosis of human disease by means of the study of cells obtained from body secretions and fluids, by scraping, washing, or sponging the surface of a lesion, or by the aspiration of a tumor mass or body organ with a fine needle. A major aspect of a cytopathologist's practice is the interpretation of Papanicolaou-stained smears of cells from the female reproductive systems, the Pap test. However, the cytopathologist's expertise is applied to the diagnosis of cells from all systems and areas of the body. He/she is a consultant to all medical specialists.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze PPO? 202 - PPO
- Blue Advantage Bronze PPO? 203 - PPO
- Blue Advantage Bronze PPO? Standard - PPO
- Blue Advantage Gold PPO? 309 - PPO
- Blue Advantage Gold PPO? 604 - PPO
- Blue Advantage Gold PPO? Standard - PPO
- Blue Advantage Silver PPO? 204 - PPO
- Blue Advantage Silver PPO? 501 - PPO
- Blue Advantage Silver PPO? Standard - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Preferred Gold PPO? Standard - PPO
- Blue Preferred Security PPO? 200 - PPO
- Blue Preferred Silver PPO? Standard - PPO
- Balance by Medica Bronze Premier - PPO
- Balance by Medica Catastrophic - PPO
- Balance by Medica Expanded Bronze Standard - PPO
- Balance by Medica Gold $0 Copay PCP Visits - PPO
- Balance by Medica Gold Standard - PPO
- Balance by Medica Silver $0 Copay PCP Visits - PPO
- Balance by Medica Silver Standard - PPO
- Harmony by Medica Bronze $0 Copay PCP Visits - PPO
- Harmony by Medica Bronze Premier - PPO
- Harmony by Medica Catastrophic - PPO
- Harmony by Medica Expanded Bronze Standard - PPO
- Harmony by Medica Gold $0 Copay PCP Visits - PPO
- Harmony by Medica Gold Standard - PPO
- Harmony by Medica Silver $0 Copay PCP Visits - PPO
- Harmony by Medica Silver Standard - PPO
- TARO Direct Primary Care Bronze 4150 ($0 DPC + $0 PCP + $0 Mental Health) - HMO
- TARO Direct Primary Care Gold $0 Ded ($0 DPC + $0 PCP + $0 Mental Health) - HMO
- TARO Direct Primary Care Silver 1900 ($0 DPC + $0 PCP + $0 Mental Health) - HMO
- TARO Standard Bronze (No Direct Primary Care, for DPC select DPC Bronze) - HMO
- TARO Standard Gold (No Direct Primary Care, for DPC select DPC Gold) - HMO
- TARO Standard Silver (No Direct Primary Care, for DPC select DPC Silver) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Michael Magguilli is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Michael Magguilli is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 7416205109
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20180813002926
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Cell examination of specimen, concentration technique
Cell examination of specimen, selective cellular enhancement technique
Cell examination of specimen, selective cellular enhancement technique
Evaluation of fine needle aspirate
Evaluation of fine needle aspirate with interpretation and report
Pap test, evaluation of fine needle aspirate, immediate, each additional evaluation episode
Pathology cytologic examination of specimen during surgery, initial site
Pathology examination of tissue using a microscope, intermediate complexity
Pathology examination of tissue using a microscope, moderately high complexity
Special stained specimen slides to examine tissue, each additional procedure
Special stained specimen slides to examine tissue, initial procedure
Special stained specimen slides to identify organisms including interpretation and report
Surgical pathology consultation and report on referred slides prepared elsewhere
Cell examination of a specimen using a concentration technique is a lab process that enhances the detection of cells in a sample. This method helps to focus on key areas of the sample, making it easier to spot abnormalities or changes. It's a crucial part of diagnosing and monitoring certain health conditions.
This service was performed 29 times for 17 patientsCell examination of a specimen using selective cellular enhancement technique is a lab process that improves the visibility of certain cells in a sample. It helps in identifying abnormalities or diseases. The process is non-invasive, safe, and aids in accurate diagnosis.
This service was performed 232 times for 193 patientsCell examination of a specimen using selective cellular enhancement technique is a lab process that improves the visibility of certain cells in a sample. It helps in identifying abnormalities or diseases. The process is non-invasive, safe, and aids in accurate diagnosis.
This service was performed 135 times for 116 patientsEvaluation of fine needle aspirate is a diagnostic procedure where a thin needle is used to collect cells from a lump or mass. This sample is then examined under a microscope to determine the nature of the lump, whether it's benign (non-cancerous) or malignant (cancerous).
This service was performed 134 times for 81 patientsThis procedure involves using a thin needle to collect a small sample from an abnormal area or lump. The sample is then examined under a microscope to identify any potential issues. A report of the findings is provided for further analysis.
This service was performed 164 times for 95 patientsA Pap test is a procedure that checks for abnormal cells in the body, which could indicate a serious condition. The evaluation of a fine needle aspirate is a process where a small sample is taken with a thin needle for examination. This can be done multiple times for a thorough analysis.
This service was performed 20 times for 18 patientsA pathology cytologic examination during surgery involves taking a small sample of cells from the initial site of concern. This sample is then examined under a microscope by a pathologist to check for any abnormal or disease-causing cells. This helps guide the ongoing surgical procedure.
This service was performed 13 times for 12 patientsA pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.
This service was performed 292 times for 186 patientsA pathology examination of tissue with moderate complexity involves a detailed study of a small tissue sample from your body. Using a microscope, experts analyze the tissue's structure and cells to identify any abnormalities. This helps in diagnosing various health conditions accurately.
This service was performed 44 times for 15 patientsSpecial stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.
This service was performed 342 times for 88 patientsThis procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.
This service was performed 98 times for 89 patientsThis service involves coloring specimen slides in a special way to help identify organisms. The colors make different parts of the organism stand out. Afterward, a detailed interpretation and report on the findings are provided.
This service was performed 40 times for 20 patientsA surgical pathology consultation involves reviewing slides prepared at a different lab to confirm or clarify a diagnosis. It's a second opinion to ensure accuracy. A report with findings and interpretations is then provided for your doctor's reference.
This service was performed 33 times for 32 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $30.76 for a new patient copayment and $23.56 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 73104 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $123.06
- Minimum New Patient Price $53
- Maximum New Patient Price $162.61
- Average New Patient Copayment $30.76
- Minimum New Patient Copayment $13.25
- Maximum New Patient Copayment $40.65
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $94.27
- Minimum Established Patient Price $16.68
- Maximum Established Patient Price $132.4
- Average Established Patient Copayment $23.56
- Minimum Established Patient Copayment $4.17
- Maximum Established Patient Copayment $33.1
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Overall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 76.47, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 76.47 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 72.32
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: N/A
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. -
Cost Score: N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. -
Cost Score: N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Michael Magguilli is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| O U MEDICAL CENTER | 700 NE 13TH STREET OKLAHOMA CITY, OK 73104 | (405) 271-5911 | Acute Care Hospitals |
Reviews for DR. MICHAEL LAWRENCE MAGGUILLI MD
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 9 | 4 | 0 | 8 | 2 | 9 | 2 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 18 | 4 | 0 | 8 | 4 | 9 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 8 + 4 + 0 + 8 + 4 + 9 + 4 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1194082925 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 14 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1083874168 | CHRYSTAL MARJENHOFF PAULEY MD Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 940 STANTON L YOUNG BLVD # 451 OKLAHOMA CITY, OK 73104 (405) 271-2451 |
| 1477713550 | BRAD ELLIOTT CHASER MD Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 940 STANTON L YOUNG BLVD # 451 OKLAHOMA CITY, OK 73104 (405) 271-2451 |
| 1881830438 | DR. JO ELLE GRACE PETERSON MD Individual | Pathology (Anatomic Pathology) | 940 STANTON L YOUNG BLVD # 451 OKLAHOMA CITY, OK 73104 (713) 206-7708 |
| 1194019232 | CHRISTOPHER L WILLIAMS MD Individual | Pathology (Clinical Pathology/Laboratory Medicine) | 940 STANTON L YOUNG BLVD # 451 OKLAHOMA CITY, OK 73104 (405) 271-2422 |
| 1285127142 | DR. PHILLIP J MINGOLA II MD Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 940 STANTON L YOUNG BLVD # 451 OKLAHOMA CITY, OK 73104 (405) 271-2451 |
| 1952962698 | ANOSHIA AFZAL MD Individual | Student in an Organized Health Care Education/Training Program | 940 STANTON L YOUNG BLVD # 451 OKLAHOMA CITY, OK 73104 (405) 271-2451 |
| 1487277075 | RANDALL SCOTT Individual | Student in an Organized Health Care Education/Training Program | 940 STANTON L YOUNG BLVD # 451 OKLAHOMA CITY, OK 73104 (405) 271-2451 |
| 1417214826 | DR. CODY ALLEN THOMAS MD Individual | Pathology (Hematology) | 940 STANTON L YOUNG BLVD # 451 OKLAHOMA CITY, OK 73104 (405) 271-2422 |
| 1023724200 | DR. SHAIMA ELGENAID MD Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 940 STANTON L YOUNG BLVD # 451 OKLAHOMA CITY, OK 73104 (405) 271-2451 |
| 1548950918 | DR. FARZAD MANAFI MD Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 940 STANTON L YOUNG BLVD # 451 OKLAHOMA CITY, OK 73104 (405) 271-2451 |
| 1639828064 | CHAD HAMILTON DO Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 940 STANTON L YOUNG BLVD # 451 OKLAHOMA CITY, OK 73104 (405) 271-2451 |
| 1366947335 | KRISTINA PETROVA DOYTCHEVA MD Individual | Pathology (Anatomic Pathology) | 940 STANTON L YOUNG BLVD # 451 OKLAHOMA CITY, OK 73104 (224) 766-1431 |
| 1699330613 | MR. TIMOTHY RAMSEYER MD Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 940 STANTON L YOUNG BLVD # 451 OKLAHOMA CITY, OK 73104 (405) 271-2451 |
| 1558088302 | JAYDEN RAY Individual | Student in an Organized Health Care Education/Training Program | 940 STANTON L YOUNG BLVD # 451 OKLAHOMA CITY, OK 73104 (405) 503-4835 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1194082925, enumerated in the NPI registry as an "individual" on April 18, 2012
The provider is located at 940 Stanton L Young Blvd # 451 Oklahoma City, Ok 73104 and the phone number is (405) 271-1515
The provider's speciality is Pathology with taxonomy code 207ZC0500X with a focus in Cytopathology
The provider has more than 14 years of experience.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Oklahoma, Medica and. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $123.06 with an average copayment of $30.76 for new patient appointments. Established patients should expect a typical charge of $94.27 and an average copayment of 23.56. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Cell examination of specimen, concentration technique, Cell examination of specimen, selective cellular enhancement technique, Cell examination of specimen, selective cellular enhancement technique, Evaluation of fine needle aspirate, Evaluation of fine needle aspirate with interpretation and report, Pap test, evaluation of fine needle aspirate, immediate, each additional evaluation episode, Pathology cytologic examination of specimen during surgery, initial site, Pathology examination of tissue using a microscope, intermediate complexity, Pathology examination of tissue using a microscope, moderately high complexity, Special stained specimen slides to examine tissue, each additional procedure, Special stained specimen slides to examine tissue, initial procedure, Special stained specimen slides to identify organisms including interpretation and report and Surgical pathology consultation and report on referred slides prepared elsewhere.
The practitioner is affiliated to the following hospital(s): O U MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on April 18, 2012. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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