MR. GORDON M HUGHES MD
NPI 1003895681
Internal Medicine - Rheumatology in Elkhart, IN

Active since January 12, 2006PECOS EnrolledAccepts Medicare Assignment
84.17/100
CMS Quality Rating
303 S NAPPANEE ST, ELKHART, IN 46514(574) 296-3200 Get Directions Write a Review

NPPES record last updated: January 3, 2019. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Mr. Gordon M Hughes Md NPPES

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

MR. GORDON M HUGHES MD (NPI 1003895681) is an individual rheumatology provider in Elkhart, Indiana, licensed in Indiana (01035437A) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS and is a graduate of Indiana University School Of Medicine (1985).

NPPES Registry Identity

NPI1003895681
Entity TypeIndividualMale
Primary Taxonomy207RR0500X
Provider Legal NameMR. GORDON M HUGHESCredential: MD
Location Address303 S NAPPANEE STElkhart, IN 46514-2098
Mailing Address800 S Tillotson AveMuncie, IN 47304-4529 · (765) 281-2000 · Fax (765) 281-2062
Sole ProprietorNo
Medical School CMSIndiana University School Of MedicineGraduated 1985
Enumeration DateJanuary 12, 2006
Last NPPES UpdateJanuary 3, 2019
✔ NPI 1003895681 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
License✔ Licensed in IN · 01035437A
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
303 S NAPPANEE ST, Elkhart, IN 46514

Other Identifiers 2

Other110035800IN · Medicare B-railroad
Medicaid100107080IN

Accepted 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

Mr. Gordon M Hughes Md 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 ID8628975513
PECOS Enrollment IDI20100614000356
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 48

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.

Injection, golimumab, 1 mg, for intravenous use J1602
Golimumab is a medication given through an IV (a small tube in your vein). It helps to reduce inflammation and pain by blocking a protein in your body that causes inflammation. It's often used to treat conditions like rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.
34,100 services38 patients
Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) J0129
Abatacept is a medication administered via injection under a doctor's supervision. It's used to treat conditions like rheumatoid arthritis by moderating the immune system. This code applies when the doctor administers the drug, not for self-administration.
30,301 services46 patients
Injection, infliximab, excludes biosimilar, 10 mg J1745
Infliximab is a medication given via injection to treat certain autoimmune conditions. It works by blocking the action of a substance in your body that causes inflammation. Each dose is based on your medical condition and response to treatment.
9,860 services30 patients
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml Q9967
Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.
7,885 services95 patients
Injection, gadobutrol, 0.1 ml A9585
Gadobutrol is a contrast agent used during MRI scans to help provide clearer images. It's injected into your vein before the scan. This helps doctors to see certain areas more clearly for better diagnosis. It's generally safe with few side effects.
3,550 services40 patients
Injection, denosumab, 1 mg J0897
Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.
2,340 services26 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46514 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
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
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.

84.17/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality71.22
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Breast Cancer Screening
51%642 patients3/55-star benchmark: 93%
Colorectal Cancer Screening
44%1,073 patients3/55-star benchmark: 88%
Controlling High Blood Pressure
88%491 patients4/55-star benchmark: 91%
Diabetes: Eye Exam
36%198 patients2/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
17%198 patients4/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
98%3,013 patients4/55-star benchmark: 100%
e-Prescribing
98%1,849 patients4/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
100%538 patients5/55-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.

Clinic/Center (Multi-Specialty)
303 S NAPPANEE ST
ELKHART, IN 46514
Internal Medicine (Rheumatology)
303 S NAPPANEE ST
ELKHART, IN 46514
Hospitalist
303 S NAPPANEE ST
ELKHART, IN 46514
Nurse Practitioner (Family)
303 S NAPPANEE ST
ELKHART, IN 46514
Podiatrist
303 S NAPPANEE ST
ELKHART, IN 46514
Nurse Practitioner (Family)
303 S NAPPANEE ST
ELKHART, IN 46514
Audiologist
303 S NAPPANEE ST
ELKHART, IN 46514
Internal Medicine
303 S NAPPANEE ST
ELKHART, IN 46514

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 Gordon Hughes's NPI number?

The NPI number for Gordon Hughes is 1003895681. It was assigned to this individual provider in the NPPES registry on January 12, 2006.

Where is Gordon Hughes located?

Gordon Hughes practices at 303 S Nappanee St, Elkhart, IN 46514. The listed phone number is (574) 296-3200.

What is Gordon Hughes's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Gordon Hughes enrolled in Medicare?

Yes. Gordon Hughes 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 Gordon Hughes accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and CareSource list Gordon Hughes 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.

When was this NPI record last updated?

The NPPES record for Gordon Hughes was last updated on January 3, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.