JAMES ANTHONY GERARDO M.D., PH.D.
NPI 1306046438
Internal Medicine - Cardiovascular Disease in Altoona, PA

Q: What is James Gerardo's NPI number?

The NPI number for James Gerardo is 1306046438. It was assigned to this individual provider in the NPPES registry on July 18, 2007.

Q: What is James Gerardo's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Q: When was this NPI record last updated?

The NPPES record for James Gerardo was last updated on May 8, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 July 18, 2007PECOS EnrolledAccepts Medicare Assignment

72.57/100

CMS Quality Rating

1321 11TH AVE, ALTOONA, PA 16601(814) 942-2411(814) 296-2040 Get Directions Write a Review

NPPES record last updated: May 8, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About James Anthony Gerardo M.d., Ph.d. NPPES

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

JAMES ANTHONY GERARDO M.D., PH.D. (NPI 1306046438) is an individual cardiovascular disease provider in Altoona, Pennsylvania, licensed in Pennsylvania (MD437970) and active in the NPI registry since July 2007. He is enrolled in Medicare PECOS, is affiliated with Geisinger Medical Center, and is a graduate of Brody School Of Medicine At East Carolina University (2002).

NPPES Registry Identity

NPI1306046438

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NameJAMES ANTHONY GERARDOCredential: M.D., PH.D.

Location Address1321 11TH AVEAltoona, PA 16601-3301

Mailing Address1321 11th AveAltoona, PA 16601-3301 · (814) 942-2411 · Fax (814) 296-2040

Phone(814) 942-2411

Fax(814) 296-2040

Sole ProprietorNo

Medical School CMSBrody School Of Medicine At East Carolina UniversityGraduated 2002

Enumeration DateJuly 18, 2007

Last NPPES UpdateMay 8, 2019

✔ NPI 1306046438 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

License✔ Licensed in PA · MD437970

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Also ListedInternal MedicineTaxonomy 207R00000X · License MD437970 (PA)

1321 11TH AVE, Altoona, PA 16601

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Other Identifiers 1

Medicaid102367966PA

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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

James Anthony Gerardo M.d., Ph.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 ID648324160

PECOS Enrollment IDI20090819000066

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.

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.

89 services72 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

50 services50 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

43 services43 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

39 services39 patients

Injection, perflutren lipid microspheres, per ml Q9957

Perflutren lipid microspheres injection, per ml, is a diagnostic tool used to enhance ultrasound images. It contains tiny gas-filled bubbles that improve the clarity of the images, aiding in a more accurate diagnosis.

37 services15 patients

Insertion of tube in coronary artery for diagnosis with review by radiologist 93454

This procedure involves placing a small tube into your coronary artery. It helps to identify any blockages or issues within the artery. A radiologist, a doctor specialized in medical imaging, will review the results to ensure accurate diagnosis.

36 services36 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

35 services35 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

30 services29 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.

28 services23 patients

Ultrasonic guidance for blood vessel access 76937

Ultrasonic guidance for blood vessel access is a medical procedure where sound waves are used to create images of your blood vessels. This helps doctors to accurately locate and access the vessels for treatments or tests, ensuring safety and precision.

23 services23 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

22 services22 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

14 services14 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

14 services14 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

14 services14 patients

Removal of plaque and blood clot, insertion of stent and/or balloon dilation of single vessel 92941

This procedure involves removing plaque, a substance that can block your blood vessels, and any blood clots. A stent, a tiny tube, may be inserted to keep the vessel open. If necessary, a balloon is inflated to widen the vessel, aiding blood flow.

11 services11 patients

Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional 93228

An Electrocardiogram (ECG) is a non-invasive test that records the electrical signals in your heart. For up to 30 days, a small device will continuously monitor your heart's activity. A healthcare professional will then review the data and provide a report on your heart's function.

11 services11 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Geisinger Medical Center

Acute Care Hospitals · Danville, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390006

Location100 North Academy AvenueDanville, PA 17822 · Montour County

Emergency services Birthing friendly

Geisinger-Lewistown Hospital

Acute Care Hospitals · Lewistown, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390048

Location400 Highland AvenueLewistown, PA 17044 · Mifflin County

Emergency services Birthing friendly

Mount Nittany Medical Center

Acute Care Hospitals · State College, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390268

Location1800 East Park AveState College, PA 16803 · Centre County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16601 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

$68.36 typical visit price

range $17.33 – $135.84

Typical copayment $17.09 (range $4.33 – $33.96)

Most-billed visit code 99213

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.

72.57/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

55.12

Promoting Interoperability

Improvement Activities

Cost

55.13

Reported Quality Measures

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…

53%123 patients3/55-star benchmark: 100%

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.

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Other Providers at the Same Location NPPES 12

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

DEZARAE L SMITH CRNP

Nurse Practitioner