DR. HEMAL GADA MD
NPI 1386852390
Internal Medicine - Cardiovascular Disease in Wormleysburg, PA
About Dr. Hemal Gada Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. HEMAL GADA MD (NPI 1386852390) is an individual cardiovascular disease provider in Wormleysburg, Pennsylvania, licensed in Pennsylvania (MD456155) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Penn Highlands Huntingdon, and is a graduate of University Of Michigan Medical School (2005).
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 1
Accepted 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. Hemal Gada 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.
Medicare Billing Reassignments
2Medicare enrollment records show Hemal Gada reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Roaring Spring, PA 16673
- Reassigned Medicare billing, Pennsylvania enrollment
- 771 clinicians in this Medicare group
Altoona, PA 16601
- Reassigned Medicare billing, Pennsylvania enrollment
- 27 clinicians in this Medicare group
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 13
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.
Hospital Affiliations CMS Care Compare 5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Penn Highlands Huntingdon
Acute Care Hospitals · Huntingdon, PAConemaugh Nason Medical Center
Acute Care Hospitals · Roaring Spring, PAUpmc Pinnacle Hospitals
Acute Care Hospitals · Harrisburg, PAUpmc Altoona
Acute Care Hospitals · Altoona, PAConemaugh Memorial Medical Center
Acute Care Hospitals · Johnstown, PAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 17043 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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.
WORMLEYSBURG, PA 17043
WORMLEYSBURG, PA 17043
WORMLEYSBURG, PA 17043
WORMLEYSBURG, PA 17043
WORMLEYSBURG, PA 17043
WORMLEYSBURG, PA 17043
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 Hemal Gada's NPI number?
The NPI number for Hemal Gada is 1386852390. It was assigned to this individual provider in the NPPES registry on May 21, 2007.
Where is Hemal Gada located?
Hemal Gada practices at 1000 N Front St, Wormleysburg, PA 17043. The listed phone number is (717) 731-0101.
What is Hemal Gada's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.
Is Hemal Gada enrolled in Medicare?
Yes. Hemal Gada 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.
Which organizations bill Medicare for Hemal Gada's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Hemal Gada reassigns Medicare benefits to 2 organizations: Dlp Conemaugh Physician Practices LLC (Roaring Spring, PA) and Cardiology Associates Of Altoona, LLP (Altoona, PA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Hemal Gada's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Hemal Gada accept?
Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Hemal Gada 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 Hemal Gada affiliated with any hospitals?
According to CMS data, Hemal Gada is affiliated with Penn Highlands Huntingdon, Conemaugh Nason Medical Center, Upmc Pinnacle Hospitals, Upmc Altoona and Conemaugh Memorial Medical Center.
When was this NPI record last updated?
The NPPES record for Hemal Gada was last updated on January 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Dr. Hemal Gada, MD · NPI 1386852390
Cardiovascular Disease physician in Wormleysburg, Pennsylvania. Individual provider, active in the CMS NPPES registry since May 21, 2007.
## Identity
- **NPI:** 1386852390 (Entity type: Individual)
- **Enumerated:** May 21, 2007
- **Primary specialty:** Internal Medicine - Cardiovascular Disease · taxonomy 207RC0000X
- **State license:** MD456155 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 1000 N FRONT ST, Wormleysburg, PA 17043-1021
- **Phone:** (717) 731-0101 · **Fax:** (717) 731-8539
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Dlp Conemaugh Physician Practices LLC (NPI 1245742188, Roaring Spring, PA); Cardiology Associates Of Altoona, LLP (NPI 1386688299, Altoona, PA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Michigan Medical School, class of 2005
## Record status
- **NPPES last updated:** January 2, 2021
- **Other identifiers:** Medicaid 103056503 (PA)
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Source: [NPI Profile](https://npiprofile.com/npi/1386852390) · Data from the CMS NPPES public registry.