BALBIR GANDHI MD
NPI 1265442024
Psychiatry & Neurology - Neurology in Wyandotte, MI

Active since August 08, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
2025 FORD AVE, WYANDOTTE, MI 48192(734) 281-3080 Get Directions Write a Review

NPPES record last updated: January 27, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Balbir Gandhi Md NPPES

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

BALBIR GANDHI MD (NPI 1265442024) is an individual neurology provider in Wyandotte, Michigan, licensed in Michigan (4301056606) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Beaumont Hospital - Dearborn, and is a graduate of Other (1982).

NPPES Registry Identity

NPI1265442024
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameBALBIR GANDHICredential: MD
Location Address2025 FORD AVEWyandotte, MI 48192-2312
Mailing Address2025 Ford AveWyandotte, MI 48192-2312 · (734) 281-3080
Sole ProprietorYes
Medical School CMSOtherGraduated 1982
Enumeration DateAugust 8, 2006
Last NPPES UpdateJanuary 27, 2010
NPI 1265442024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License Licensed in MI · 4301056606
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
2025 FORD AVE, Wyandotte, MI 48192

Other Identifiers 3

Medicare UPINF93286MI
Medicare PINOP36490001MI
Medicaid103340140MI

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

Balbir Gandhi 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 ID345247615
PECOS Enrollment IDI20061030000173
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 17

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.
288 services116 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.
268 services167 patients
Needle measurement of electrical activity in arm or leg muscles, complete study 95886
This procedure, known as an electromyography (EMG), involves inserting a small needle into your arm or leg muscles to measure their electrical activity. This complete study helps diagnose issues with nerves or muscles, providing valuable data for your treatment plan.
145 services86 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.
135 services94 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.
112 services108 patients
Measurement of brain wave activity (eeg), awake and asleep 95819
The measurement of brain wave activity, known as an EEG, records the brain's electrical signals. It's performed when you're awake and asleep to monitor your brain's functioning. It helps in diagnosing conditions like epilepsy, sleep disorders, and other neurological issues.
75 services70 patients

Hospital Affiliations CMS Care Compare 5

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

Beaumont Hospital - Dearborn

Acute Care Hospitals · Dearborn, MI
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230020
Location18101 Oakwood BlvdDearborn, MI 48124 · Wayne County
Emergency services Birthing friendly

Henry Ford Health Hospital

Acute Care Hospitals · Detroit, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230053
Location2799 W Grand BlvdDetroit, MI 48202 · Wayne County
Emergency services Birthing friendly

Henry Ford Health Wyandotte Hospital

Acute Care Hospitals · Wyandotte, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230146
Location2333 Biddle AveWyandotte, MI 48192 · Wayne County
Emergency services Birthing friendly

Corewell Health Trenton Hospital

Acute Care Hospitals · Trenton, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230176
Location5450 Fort StreetTrenton, MI 48183 · Wayne County
Emergency services Birthing friendly

Beaumont Hospital - Taylor

Acute Care Hospitals · Taylor, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230270
Location10000 Telegraph RoadTaylor, MI 48180 · Wayne County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48192 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
$134.28 typical visit price
range $58.04 – $177.36
Typical copayment $33.57 (range $14.51 – $44.34)
Most-billed visit code 99204
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality94.72
Promoting Interoperability100
Improvement Activities40
Cost77.03

Reported Quality Measures

Anti-Depressant Medication Management
Percentage of patients 18 years of age and older who were treated with antidepressant medication, had a diagnosis of major depression, and who remained on an antidepressant medication treatment.
38%26 patients
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
46%242 patients3/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
25%257 patients
Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
1%405 patients1/55-star benchmark: 95%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
38%492 patients2/55-star benchmark: 85%
Depression Utilization of the PHQ-9 Tool
The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit
Patients 4MonthsOfEnd: 11% · 61 patients
Patients 4MonthsOfStart: 27% · 49 patients
19%69 patients
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
5%172 patients1/55-star benchmark: 100%
Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
21%172 patients1/55-star benchmark: 98%
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
91%172 patients4/55-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.
91%2,320 patients4/55-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.
95%384 patients4/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
34%263 patients2/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
88%556 patients2/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
96%435 patients4/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
34%266 patients2/55-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…
50%905 patients3/55-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
24%639 patients2/55-star benchmark: 88%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
22%720 patients1/55-star benchmark: 96%
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 screenedForUse: 100% · 599 patients
Patients tobacco: 82% · 599 patients
13%120 patients1/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%435 patients5/55-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 CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
7%435 patients1/55-star benchmark: 89%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: - Adults aged >= 21 years who were previously diagnosed with or currently have an active…
73%423 patients4/55-star benchmark: 89%
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+: 2% · 266 patients
5%266 patients4/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
31%435 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.

Referred Medical Equipment & Supplies CMS DME claims 12

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
8 suppliers28 claims28 services$31.93 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
6 suppliers23 claims23 services$71.61 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
4 suppliers22 claims42 services$27.18 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
7 suppliers22 claims94 services$14.43 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
6 suppliers26 claims26 services$44.43 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
8 suppliers33 claims33 services$15.04 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Acute Care)
2025 FORD AVE
WYANDOTTE, MI 48192
Internal Medicine (Pulmonary Disease)
2025 FORD AVE
WYANDOTTE, MI 48192
Psychiatry & Neurology (Neurology)
2025 FORD AVE
WYANDOTTE, MI 48192
Physician Assistant (Medical)
2025 FORD AVE, STE. 100
WYANDOTTE, MI 48192
Specialist
2025 FORD AVE
WYANDOTTE, MI 48192
Internal Medicine (Pulmonary Disease)
2025 FORD AVE
WYANDOTTE, MI 48192

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 Balbir Gandhi's NPI number?

The NPI number for Balbir Gandhi is 1265442024. It was assigned to this individual provider in the NPPES registry on August 8, 2006.

Where is Balbir Gandhi located?

Balbir Gandhi practices at 2025 Ford Ave, Wyandotte, MI 48192. The listed phone number is (734) 281-3080.

What is Balbir Gandhi's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Balbir Gandhi enrolled in Medicare?

Yes. Balbir 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 Balbir Gandhi accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 1 other insurer list Balbir 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.

Is Balbir Gandhi affiliated with any hospitals?

According to CMS data, Balbir Gandhi is affiliated with Beaumont Hospital - Dearborn, Henry Ford Health Hospital, Henry Ford Health Wyandotte Hospital, Corewell Health Trenton Hospital and Beaumont Hospital - Taylor.

When was this NPI record last updated?

The NPPES record for Balbir Gandhi was last updated on January 27, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.