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SUSHEER GANDOTRA M.D.
NPI 1083663694
Internal Medicine - Infectious Disease in East Stroudsburg, PA

Active since May 09, 2006PECOS EnrolledAccepts Medicare Assignment
79.45/100
CMS Quality Rating
175 E BROWN ST, SUITE 114, EAST STROUDSBURG, PA 18301(570) 426-2301(570) 426-2306 Get Directions Write a Review

NPPES record last updated: December 29, 2010. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Susheer Gandotra M.d. NPPES

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

SUSHEER GANDOTRA M.D. (NPI 1083663694) is an individual infectious disease provider in East Stroudsburg, Pennsylvania, licensed in Pennsylvania (MD435097) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Lehigh Valley Hospital, and is a graduate of Other (1999).

NPPES Registry Identity

NPI1083663694
Entity TypeIndividualMale
Primary Taxonomy207RI0200X
Provider Legal NameSUSHEER GANDOTRACredential: M.D.
Location Address175 E BROWN ST, SUITE 114East Stroudsburg, PA 18301-3098
Mailing Address206 E. Brown St., Pocono Healthcare Mgmt.-professional CenterEast Stroudsburg, PA 18301 · (570) 420-4951 · Fax (570) 476-3754
Phone(570) 426-2301
Fax(570) 426-2306
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateMay 9, 2006
Last NPPES UpdateDecember 29, 2010
✔ NPI 1083663694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
Licenses✔ Licensed in PA · MD435097✔ Licensed in DE · C1-0008498
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
175 E BROWN ST, East Stroudsburg, PA 18301
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Other Identifiers 3

Other1083663694DE · Npi
Medicare PIN843314LJYPA
Medicaid1021961250001PA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Susheer Gandotra M.d. 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 ID9234147380
PECOS Enrollment IDI20080909000279
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Susheer Gandotra reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Family Care Centers Inc.
Same address
Internal Medicine
206 E BROWN ST
E Stroudsburg, PA 18301
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 500 clinicians in this Medicare group
NPI 1669563037 (570) 476-3507
Lehigh Valley Physician Group
0.1 mi
Family Medicine
200 E BROWN ST
East Stroudsburg, PA 18301
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 2,895 clinicians in this Medicare group
NPI 1366236937 (272) 762-4378

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
273 services127 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
194 services69 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
85 services78 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
68 services68 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
53 services32 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
40 services30 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lehigh Valley Hospital

Acute Care Hospitals · Allentown, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390133
Location1200 South Cedar Crest BoulevardAllentown, PA 18103 · Lehigh County
Emergency services Birthing friendly

Lehigh Valley Hospital - Pocono

Acute Care Hospitals · East Stroudsburg, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390201
Location206 East Brown StreetEast Stroudsburg, PA 18301 · Monroe County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18301 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

79.45/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality80.12
Promoting Interoperability86
Improvement Activities40
Cost60.65

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.

DR. THOMAS MICHAEL PAPA MD
Internal Medicine (Infectious Disease)
175 E BROWN ST, SUITE 114
EAST STROUDSBURG, PA 18301
Monroe County (570) 426-2301
MS. CAROL STANEK CRNP
Nurse Practitioner (Family)
175 E BROWN ST
EAST STROUDSBURG, PA 18301
Monroe County (570) 420-6450
DR. SHANDURAI TEURAI TAKAVARASHA M.D.
Internal Medicine (Infectious Disease)
175 E BROWN ST
EAST STROUDSBURG, PA 18301
Monroe County (570) 426-2840
POCONO ORTHOPAEDICS SURGERY
Orthopaedic Surgery
175 E BROWN ST, SUITE 114
EAST STROUDSBURG, PA 18301
Monroe County (570) 426-2301
SUSHIL S. MODY MD
Pediatrics
175 E BROWN ST, SUITE 108
E STROUDSBURG, PA 18301
Monroe County (570) 476-3585
KIMBERLY DOWNES DO
Pediatrics
175 E BROWN ST
EAST STROUDSBURG, PA 18301
Monroe County (570) 476-3585
DR. JOSE R BORDAS M.D.
Pediatrics
175 E BROWN ST, SUITE 108
EAST STROUDSBURG, PA 18301
Monroe County (570) 476-3585
PHILIP H. LAWRENCE MD
Obstetrics & Gynecology
175 E BROWN ST, POCONO OBSTETRICS AND GYNECOLOGY, SUITE 113
EAST STROUDSBURG, PA 18301
Monroe County (570) 421-3401

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 Susheer Gandotra's NPI number?

The NPI number for Susheer Gandotra is 1083663694. It was assigned to this individual provider in the NPPES registry on May 9, 2006.

Where is Susheer Gandotra located?

Susheer Gandotra practices at 175 E Brown St Suite 114, East Stroudsburg, PA 18301. The listed phone number is (570) 426-2301.

What is Susheer Gandotra's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Susheer Gandotra enrolled in Medicare?

Yes. Susheer Gandotra 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.

Which organizations bill Medicare for Susheer Gandotra's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Susheer Gandotra reassigns Medicare benefits to 2 organizations: Family Care Centers Inc. (E Stroudsburg, PA) and Lehigh Valley Physician Group (East Stroudsburg, PA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Susheer Gandotra's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Susheer Gandotra accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Susheer Gandotra 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.

Is Susheer Gandotra affiliated with any hospitals?

According to CMS data, Susheer Gandotra is affiliated with Lehigh Valley Hospital and Lehigh Valley Hospital - Pocono.

When was this NPI record last updated?

The NPPES record for Susheer Gandotra was last updated on December 29, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.