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DR. GHANSHYAM HIMMATBHAI GHELANI M.D.
NPI 1407297385
Internal Medicine - Hematology & Oncology in Tyler, TX

Active since July 08, 2013PECOS EnrolledAccepts Medicare Assignment
721 CLINIC DR, TYLER, TX 75701(903) 592-0629 Get Directions Write a Review

NPPES record last updated: June 24, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Ghanshyam Himmatbhai Ghelani M.d. NPPES

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

DR. GHANSHYAM HIMMATBHAI GHELANI M.D. (NPI 1407297385) is an individual hematology & oncology provider in Tyler, Texas, licensed in Texas (U9533) and active in the NPI registry since July 2013. He is enrolled in Medicare PECOS, is affiliated with Ut Health East Texas Tyler Regional Hospital, and maintains a secondary practice location in Scranton.

NPPES Registry Identity

NPI1407297385
Entity TypeIndividualMale
Primary Taxonomy207RH0003X
Provider Legal NameDR. GHANSHYAM HIMMATBHAI GHELANICredential: M.D.
Location Address721 CLINIC DRTyler, TX 75701-2043
Mailing Address11937 Us Highway 271Tyler, TX 75708-3154 · (903) 877-7200
Phone(903) 592-0629
Sole ProprietorYes
Medical School CMSOtherGraduated 2008
Enumeration DateJuly 8, 2013
Last NPPES UpdateJune 24, 2024
NPPES CertifiedJune 24, 2024
✔ NPI 1407297385 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
License✔ Licensed in TX · U9533
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Also ListedInternal MedicineTaxonomy 207R00000X · License MT203125 (PA)
721 CLINIC DR, Tyler, TX 75701
Open in Google Maps ↗

Secondary Practice Location 1

Location 1501 Madison Ave, Second FloorScranton, PA 18510-2401 · Phone (570) 343-2383 ext. 2401

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Ghanshyam Himmatbhai Ghelani M.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 ID840591590
PECOS Enrollment IDI20240530000242
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

2

Medicare enrollment records show Ghanshyam Ghelani reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Etmc Physician Group Inc.
0.2 mi
Cardiovascular Disease
1000 S BECKHAM AVE
Tyler, TX 75701
  • Reassigned Medicare billing, Texas enrollment
  • 636 clinicians in this Medicare group
NPI 1609382662 (903) 590-5611
University Of Texas Health Science Center At Tyler
5.0 mi
Nurse Anesthetist, Certified Registered
11937 US HIGHWAY 271
Tyler, TX 75708
  • Reassigned Medicare billing, Texas enrollment
  • Medicare enrollment name: University Of Texas Health Science Center At Tyler-Facilty-Physician
  • 299 clinicians in this Medicare group
NPI 1992868186 (903) 877-7777

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 3

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.
43 services37 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.
28 services28 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.
24 services22 patients

Hospital Affiliations CMS Care Compare 5

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

Ut Health East Texas Tyler Regional Hospital

Acute Care Hospitals · Tyler, TX
1/5 CMS rating
OwnershipProprietary
CMS Certification Number450083
Location1000 South Beckham AveTyler, TX 75701 · Smith County
Emergency services Birthing friendly

Christus Mother Frances Hospital

Acute Care Hospitals · Tyler, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450102
Location800 East DawsonTyler, TX 75701 · Smith County
Emergency services Birthing friendly

Ut Health East Texas Jacksonville Hospital

Acute Care Hospitals · Jacksonville, TX
OwnershipProprietary
CMS Certification Number450194
Location501 S RagsdaleJacksonville, TX 75766 · Cherokee County
Emergency services Birthing friendly

Ut Health East Texas Athens Hospital

Acute Care Hospitals · Athens, TX
2/5 CMS rating
OwnershipProprietary
CMS Certification Number450389
Location2000 South Palestine StAthens, TX 75751 · Henderson County
Emergency services Birthing friendly
4/5 CMS rating
OwnershipGovernment - State
CMS Certification Number450690
Location11937 Us Highway 271Tyler, TX 75708 · Smith County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75701 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
$166.88 typical visit price
range $54.84 – $166.88
Typical copayment $41.72 (range $13.71 – $41.72)
Most-billed visit code 99205
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

Other Providers at the Same Location NPPES 15

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

JEFFREY GILROY MD PA
Radiology (Therapeutic Radiology)
721 CLINIC DR
TYLER, TX 75701
Smith County (903) 595-5550
TYLER HEMATOLOGY ONCOLOGY, P.A.
Internal Medicine (Hematology & Oncology)
721 CLINIC DR, STE A
TYLER, TX 75701
Smith County (903) 592-6152
EAST TEXAS MEDICAL CENTER CANCER INSTITUTE
Radiology (Radiation Oncology)
721 CLINIC DR
TYLER, TX 75701
Smith County (903) 595-5550
MRS. MYRTHA BASILE M.D.
Internal Medicine (Hematology & Oncology)
721 CLINIC DR, STE A
TYLER, TX 75701
Smith County (903) 592-6152
DR. KATRINA Y. GLOVER M.D.
Internal Medicine (Hematology & Oncology)
721 CLINIC DR, STE A
TYLER, TX 75701
Smith County (903) 592-6152
DR. BRANDON ASHTON M.D.
Radiology (Diagnostic Radiology)
721 CLINIC DR
TYLER, TX 75701
Smith County (903) 535-6301
ANNALA J. SHIRLEY NP-C
Nurse Practitioner
721 CLINIC DR, STE A
TYLER, TX 75701
Smith County (903) 595-7014
DR. ROBERT DRODER M.D.
Internal Medicine (Hematology & Oncology)
721 CLINIC DR, STE A
TYLER, TX 75701
Smith County (903) 592-6152

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 Ghanshyam Ghelani's NPI number?

The NPI number for Ghanshyam Ghelani is 1407297385. It was assigned to this individual provider in the NPPES registry on July 8, 2013.

Where is Ghanshyam Ghelani located?

Ghanshyam Ghelani practices at 721 Clinic Dr, Tyler, TX 75701. The listed phone number is (903) 592-0629.

What is Ghanshyam Ghelani's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Is Ghanshyam Ghelani enrolled in Medicare?

Yes. Ghanshyam Ghelani 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 Ghanshyam Ghelani's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ghanshyam Ghelani reassigns Medicare benefits to 2 organizations: Etmc Physician Group Inc. (Tyler, TX) and University Of Texas Health Science Center At Tyler (Tyler, TX). 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 Ghanshyam Ghelani's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ghanshyam Ghelani 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 2 other insurers list Ghanshyam Ghelani 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 Ghanshyam Ghelani affiliated with any hospitals?

According to CMS data, Ghanshyam Ghelani is affiliated with Ut Health East Texas Tyler Regional Hospital, Christus Mother Frances Hospital, Ut Health East Texas Jacksonville Hospital, Ut Health East Texas Athens Hospital and The University Of Texas Health Science Center At Tyler.

When was this NPI record last updated?

The NPPES record for Ghanshyam Ghelani was last updated on June 24, 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.