DR. MAMATHA GANDHI MBBS
NPI 1154587897
Internal Medicine - Nephrology in Birmingham, AL

Active since August 01, 2008PECOS EnrolledAccepts Medicare Assignment
8.87/100
CMS Quality Rating
619 19TH ST S, BIRMINGHAM, AL 35233(205) 934-4011 Get Directions Write a Review

NPPES record last updated: August 7, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 7, 2024, Jul 21, 2022 (2 updates tracked since 2022).

About Dr. Mamatha Gandhi Mbbs NPPES

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

DR. MAMATHA GANDHI MBBS (NPI 1154587897) is an individual nephrology provider in Birmingham, Alabama, licensed in Alabama (30960) and active in the NPI registry since August 2008. She is enrolled in Medicare PECOS, maintains a secondary practice location in Birmingham, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1154587897
Entity TypeIndividualFemale
Primary Taxonomy207RN0300X
Provider Legal NameDR. MAMATHA GANDHICredential: MBBS
Location Address619 19TH ST SBirmingham, AL 35233-1900
Mailing AddressPo Box 55310Birmingham, AL 35255-5310
Sole ProprietorYes
Medical School CMSOtherGraduated 2005
Enumeration DateAugust 1, 2008
Last NPPES UpdateAugust 7, 20242 updates tracked since enumeration
NPPES CertifiedAugust 7, 2024
NPI 1154587897 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License Licensed in AL · 30960
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
619 19TH ST S, Birmingham, AL 35233

Secondary Practice Location 1

Location 13570 Grandview Pkwy Ste 101Birmingham, AL 35243-2065 · Phone (205) 354-2100 · Fax (866) 343-6766

Other Identifiers 1

Medicaid171183AL

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

Dr. Mamatha Gandhi Mbbs 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 ID1052589165
PECOS Enrollment IDI20110715000355
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 11

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 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.
180 services59 patients
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.
123 services65 patients
Hemodialysis procedure with physician evaluation 90935
Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.
71 services31 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.
45 services41 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.
43 services42 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
31 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35233 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
$122.31 typical visit price
range $52.65 – $161.63
Typical copayment $30.57 (range $13.16 – $40.40)
Most-billed visit code 99204
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
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.

8.87/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0
Cost29.59

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
98%123 patients4/55-star benchmark: 100%
Clinical Information Reconciliation
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation.
2%43 patients1/55-star benchmark: 100%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
100%70 patients5/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%370 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
94%271 patients4/55-star benchmark: 100%
Patient-Generated Health Data
Patient-generated health data or data from a non-clinical setting is incorporated into the certified EHR technology for at least one unique patient seen by the MIPS eligible clinician during the performance period.
1%207 patients
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…
4%207 patients1/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
84%121 patients4/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
18%196 patients1/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
85%53 patients4/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients tobacco: 100% · 116 patients
100%116 patients
Provide Patient Access
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…
95%207 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in…
2%207 patients1/55-star benchmark: 75%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 123 patients
1%123 patients4/55-star benchmark: 100%
View, Download and Transmit (VDT)
During the performance period, at least one unique patient (or patient-authorized representatives) seen by the MIPS eligible clinician actively engages with the EHR made accessible by the MIPS eligible clinician.
5%207 patients
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.

Emergency Medicine (Medical Toxicology)
619 19TH ST S
BIRMINGHAM, AL 35233
Registered Nurse
619 19TH ST S
BIRMINGHAM, AL 35233
Physician Assistant
619 19TH ST S
BIRMINGHAM, AL 35233
Emergency Medicine
619 19TH ST S
BIRMINGHAM, AL 35233
Hospitalist
619 19TH ST S
BIRMINGHAM, AL 35233
Radiology (Diagnostic Radiology)
619 19TH ST S
BIRMINGHAM, AL 35233
Internal Medicine (Hematology)
619 19TH ST S
BIRMINGHAM, AL 35233
Surgery (Trauma Surgery)
619 19TH ST S
BIRMINGHAM, AL 35233

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 Mamatha Gandhi's NPI number?

The NPI number for Mamatha Gandhi is 1154587897. It was assigned to this individual provider in the NPPES registry on August 1, 2008.

Where is Mamatha Gandhi located?

Mamatha Gandhi practices at 619 19th St S, Birmingham, AL 35233. The listed phone number is (205) 934-4011.

What is Mamatha Gandhi's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Mamatha Gandhi enrolled in Medicare?

Yes. Mamatha Gandhi 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 Mamatha Gandhi accept?

Health plans from Ambetter Health, Ambetter from Magnolia Health, Ambetter of Alabama, Ambetter of Tennessee and Blue Cross and Blue Shield of Alabama list Mamatha Gandhi 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 Mamatha Gandhi was last updated on August 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.