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DR. AHMED MUHAMMAD S GHADAI M.D
NPI 1447504402
Internal Medicine - Critical Care Medicine in Janesville, WI

Active since October 30, 2012PECOS EnrolledAccepts Medicare Assignment
94.1/100
CMS Quality Rating
1000 MINERAL POINT AVE, JANESVILLE, WI 53548(608) 756-6868 Get Directions Write a Review

NPPES record last updated: January 23, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 28, 2021, Jul 15, 2020, Jun 10, 2020 and 2 more (5 updates tracked since 2015).

About Dr. Ahmed Muhammad S Ghadai M.d NPPES

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

DR. AHMED MUHAMMAD S GHADAI M.D (NPI 1447504402) is an individual critical care medicine provider in Janesville, Wisconsin, licensed in Indiana (01075661A) and active in the NPI registry since October 2012. He is enrolled in Medicare PECOS, is affiliated with Northwestern Medicine Mchenry, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1447504402
Entity TypeIndividualMale
Primary Taxonomy207RC0200X
Provider Legal NameDR. AHMED MUHAMMAD S GHADAICredential: M.D
Location Address1000 MINERAL POINT AVEJanesville, WI 53548-2940
Mailing Address29624 Network PlChicago, IL 60673-1296 · (608) 756-6278
Phone(608) 756-6868
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateOctober 30, 2012
Last NPPES UpdateJanuary 23, 20255 updates tracked since enumeration
NPPES CertifiedJanuary 23, 2025
✔ NPI 1447504402 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RC0200X
Licenses✔ Licensed in IN · 01075661A✔ Licensed in IL · 036.138231
Definition
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License 01075661A (IN), 036.138231 (IL)
1000 MINERAL POINT AVE, Janesville, WI 53548
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Other Identifiers 1

Medicaid036138231IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Texas.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

Dr. Ahmed Muhammad S Ghadai 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 ID1254573884
PECOS Enrollment IDI20200626000748, I20250130002843
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 6

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.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
201 services112 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.
108 services74 patients
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.
101 services68 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.
41 services41 patients
Insertion of non-tunneled central venous tube for infusion (5 years or older) 36556
This procedure involves placing a thin tube into a large vein, usually in the neck or chest, to administer medication or fluids. It's done under local anesthesia to minimize discomfort. It's a standard, safe procedure for individuals aged 5 and above.
23 services22 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
13 services13 patients

Hospital Affiliations CMS Care Compare 5

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

Northwestern Medicine Mchenry

Acute Care Hospitals · Mchenry, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number140116
Location4201 Medical Center DriveMchenry, IL 60050 · Mc Henry County
Emergency services Birthing friendly

Insight Hospital And Medical Center Chicago

Acute Care Hospitals · Chicago, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140158
Location2525 S Michigan AveChicago, IL 60616 · Cook County
Emergency services

Northwestern Medicine Kishwaukee Hospital

Acute Care Hospitals · Dekalb, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140286
LocationOne Kish Hospital DriveDekalb, IL 60115 · De Kalb County
Emergency services Birthing friendly

Valley West Community Hospital

Critical Access Hospitals · Sandwich, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141340
Location1301 North Main StreetSandwich, IL 60548 · De Kalb County
Emergency services

Mercy Health System Corp

Acute Care Hospitals · Janesville, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520066
Location1000 Mineral Point AveJanesville, WI 53548 · Rock County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53548 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

94.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality82.59
Promoting Interoperability100
Improvement Activities40

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.

BENJAMIN C. MILLER PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
1000 MINERAL POINT AVE
JANESVILLE, WI 53548
Rock County (608) 756-6508
KARINA LAURA PAULIUS QUINN MD
Plastic Surgery
1000 MINERAL POINT AVE
JANESVILLE, WI 53548
Rock County (608) 756-6000
ALESIA L DRAKE DPT, PT
Physical Therapist
1000 MINERAL POINT AVE
JANESVILLE, WI 53548
Rock County (608) 756-6842
PAULINE R CASS PHARMD
Pharmacist
1000 MINERAL POINT AVE
JANESVILLE, WI 53548
Rock County (608) 756-6000
KAREN SAUNDERS OT
Occupational Therapist
1000 MINERAL POINT AVE
JANESVILLE, WI 53548
Rock County (608) 756-6000
DR. MERLE S RUST MD
Neurological Surgery
1000 MINERAL POINT AVE, MERCY WEST NEUROSURGERY
JANESVILLE, WI 53548
Rock County (608) 756-6826
DR. MICHAEL V COOGAN MD
Emergency Medicine (Medical Toxicology)
1000 MINERAL POINT AVE
JANESVILLE, WI 53548
Rock County (608) 756-6000
CHRISTOPHER B GOODAVISH PA
Physician Assistant
1000 MINERAL POINT AVE
JANESVILLE, WI 53548
Rock County (608) 756-6868

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 Ahmed Ghadai's NPI number?

The NPI number for Ahmed Ghadai is 1447504402. It was assigned to this individual provider in the NPPES registry on October 30, 2012.

Where is Ahmed Ghadai located?

Ahmed Ghadai practices at 1000 Mineral Point Ave, Janesville, WI 53548. The listed phone number is (608) 756-6868.

What is Ahmed Ghadai's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Is Ahmed Ghadai enrolled in Medicare?

Yes. Ahmed Ghadai 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 Ahmed Ghadai accept?

Health plans from Anthem Blue Cross and Blue Shield and Blue Cross and Blue Shield of Texas list Ahmed Ghadai 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 Ahmed Ghadai affiliated with any hospitals?

According to CMS data, Ahmed Ghadai is affiliated with Northwestern Medicine Mchenry, Insight Hospital And Medical Center Chicago, Northwestern Medicine Kishwaukee Hospital, Valley West Community Hospital and Mercy Health System Corp.

When was this NPI record last updated?

The NPPES record for Ahmed Ghadai was last updated on January 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.