1. Home
  2. Directory
  3. Pennsylvania
  4. Langhorne
  5. Internal Medicine
  6. NPI Profile

SUSHMITHA GANDRA MD
NPI 1265643563
Internal Medicine - Nephrology in Langhorne, PA

Active since May 25, 2007PECOS EnrolledAccepts Medicare Assignment
240 MIDDLETOWN BLVD, SUITE 200, LANGHORNE, PA 19047(215) 757-5772(215) 757-5494 Get Directions Write a Review

NPPES record last updated: October 16, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Sushmitha Gandra Md NPPES

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

SUSHMITHA GANDRA MD (NPI 1265643563) is an individual nephrology provider in Langhorne, Pennsylvania, licensed in Pennsylvania (MD433932) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS, is affiliated with Memorial Hermann Hospital System, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1265643563
Entity TypeIndividualFemale
Primary Taxonomy207RN0300X
Provider Legal NameSUSHMITHA GANDRACredential: MD
Location Address240 MIDDLETOWN BLVD, SUITE 200Langhorne, PA 19047-1832
Mailing Address240 Middletown Blvd, Suite 200Langhorne, PA 19047-1832 · (215) 757-5772 · Fax (215) 757-5494
Phone(215) 757-5772
Fax(215) 757-5494
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateMay 25, 2007
Last NPPES UpdateOctober 16, 2012
✔ NPI 1265643563 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 PA · MD433932
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.

240 MIDDLETOWN BLVD, Langhorne, PA 19047
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.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

Sushmitha Gandra 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 ID9234218512
PECOS Enrollment IDI20170320002252
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 8

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.
900 services267 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.
337 services188 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.
125 services112 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.
117 services106 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.
115 services60 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.
59 services12 patients

Hospital Affiliations CMS Care Compare 4

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

Memorial Hermann Hospital System

Acute Care Hospitals · Houston, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450184
Location1635 North Loop WestHouston, TX 77008 · Harris County
Emergency services Birthing friendly

Hca Houston Healthcare Northwest

Acute Care Hospitals · Houston, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450638
Location710 Cypress Creek ParkwayHouston, TX 77090 · Harris County
Emergency services Birthing friendly

St Luke's The Woodlands Hospital

Acute Care Hospitals · The Woodlands, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450862
Location17200 St Luke's WayThe Woodlands, TX 77384 · Montgomery County
Emergency services Birthing friendly

Houston Methodist The Woodlands Hospital

Acute Care Hospitals · The Woodlands, TX
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number670122
Location17201 Interstate 45 SouthThe Woodlands, TX 77385 · Montgomery County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19047 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
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
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.

Reported Quality Measures

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
38%48 patients2/55-star benchmark: 88%
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 4

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

Parenteral nutrition solution, not otherwise specified, 10 grams lipids B4185
Other-Enteral and Parenteral · category OB005N
1 supplier22 claims686 services$11.36 avg. paid by Medicare
Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 grams of protein - premix B4199
Other-Enteral and Parenteral · category OB005N
1 supplier21 claims132 services$323.74 avg. paid by Medicare
Parenteral nutrition supply kit; premix, per day B4220
Other-Enteral and Parenteral · category OB005N
1 supplier22 claims139 services$8.09 avg. paid by Medicare
Parenteral nutrition administration kit, per day B4224
Other-Enteral and Parenteral · category OB005N
1 supplier22 claims139 services$25.27 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 20

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

XIA WANG M.D.
Physical Medicine & Rehabilitation
240 MIDDLETOWN BLVD, SUITE 201
LANGHORNE, PA 19047
Bucks County (215) 750-2344
JOHN PETOLILLO JR. DO
Orthopaedic Surgery
240 MIDDLETOWN BLVD, SUITE 101D
LANGHORNE, PA 19047
Bucks County (215) 750-6700
SUBURBAN ORTHOPAEDICS PC
Orthopaedic Surgery
240 MIDDLETOWN BLVD, SUITE 101D
LANGHORNE, PA 19047
Bucks County (215) 750-6700
HEARTCARE ASSOCIATES OF BUCKS COUNTY PC
Internal Medicine (Cardiovascular Disease)
240 MIDDLETOWN BLVD, SUITE -201
LANGHORNE, PA 19047
Bucks County (215) 752-9950
MS. CHRISTINE LOUISE HOOPER CRNP
Nurse Practitioner (Adult Health)
240 MIDDLETOWN BLVD, SUITE 200
LANGHORNE, PA 19047
Bucks County (215) 757-5772
OXFORD VALLEY DENTAL EXCELLENCE
Dentist
240 MIDDLETOWN BLVD, SUITE 100
LANGHORNE, PA 19047
Bucks County (215) 750-2222
ADVANCED REHAB SPECIALIST. LLC
Specialist
240 MIDDLETOWN BLVD, SUITE 201
LANGHORNE, PA 19047
Bucks County (267) 980-4622
SANDRA L TURNER CRNP
Nurse Practitioner (Adult Health)
240 MIDDLETOWN BLVD, SUITE 203
LANGHORNE, PA 19047
Bucks County (215) 750-2300

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 Sushmitha Gandra's NPI number?

The NPI number for Sushmitha Gandra is 1265643563. It was assigned to this individual provider in the NPPES registry on May 25, 2007.

Where is Sushmitha Gandra located?

Sushmitha Gandra practices at 240 Middletown Blvd Suite 200, Langhorne, PA 19047. The listed phone number is (215) 757-5772.

What is Sushmitha Gandra's specialty?

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

Is Sushmitha Gandra enrolled in Medicare?

Yes. Sushmitha Gandra 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 Sushmitha Gandra accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Sushmitha Gandra 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 Sushmitha Gandra affiliated with any hospitals?

According to CMS data, Sushmitha Gandra is affiliated with Memorial Hermann Hospital System, Hca Houston Healthcare Northwest, St Luke's The Woodlands Hospital and Houston Methodist The Woodlands Hospital.

When was this NPI record last updated?

The NPPES record for Sushmitha Gandra was last updated on October 16, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.