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

Q: 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.

Q: What is Mamatha Gandhi's specialty?

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

Q: 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.

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: October 25, 2026.

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

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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

Phone(205) 934-4011

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

Open in Google Maps ↗

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

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, Ambetter of Tennessee and more.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

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.

Medicare Billing Reassignments

Medicare enrollment records show Mamatha Gandhi reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Alabama Health Services Foundation, PC

0.9 mi

Ambulatory Surgical

2000 6TH AVE SOUTH
Birmingham, AL 35233

Reassigned Medicare billing, Alabama enrollment
4,494 clinicians in this Medicare group

NPI 1124213376 (205) 801-8000

Oak Mountain Group Services, LLC

7.5 mi

Physical Medicine & Rehabilitation

3070 HEALTHY WAY
Vestavia Hills, AL 35243

Reassigned Medicare billing, Alabama enrollment
215 clinicians in this Medicare group

NPI 1609321165 (205) 977-7216

Nephrology Medical Associates Of Georgia, LLC

7.7 mi

Nephrology

3570 GRANDVIEW PKWY STE 2
Birmingham, AL 35243

Reassigned Medicare billing, Alabama enrollment
3 clinicians in this Medicare group

NPI 1407192172 (205) 354-2100

Southern Kidney Care PC

7.7 mi

Nephrology

3570 GRANDVIEW PKWY STE 101
Birmingham, AL 35243

Reassigned Medicare billing, Alabama enrollment
6 clinicians in this Medicare group

NPI 1265020937 (205) 354-2100

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 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

Quality

Improvement Activities

Cost

29.59

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.

SASHA KAISER MD

Emergency Medicine (Medical Toxicology)