Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ASHWINI PRABHAKAR GORE M.D.
NPI 1457373565
Internal Medicine - Endocrinology, Diabetes & Metabolism in Macon, GA

Q: What is Ashwini Gore's NPI number?

The NPI number for Ashwini Gore is 1457373565. It was assigned to this individual provider in the NPPES registry on July 25, 2006.

Q: What is Ashwini Gore's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Q: When was this NPI record last updated?

The NPPES record for Ashwini Gore was last updated on September 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 days 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 25, 2006PECOS EnrolledAccepts Medicare Assignment

38.36/100

CMS Quality Rating

235 SHERATON BLVD, MACON, GA 31210(478) 746-8626(478) 746-0491 Get Directions Write a Review

NPPES record last updated: September 4, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Sep 4, 2026, Jun 6, 2023 (2 updates tracked since 2023).

On this page

About Ashwini Prabhakar Gore M.d. NPPES

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

ASHWINI PRABHAKAR GORE M.D. (NPI 1457373565) is an individual endocrinology, diabetes & metabolism provider in Macon, Georgia, licensed in Georgia (65775) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, is affiliated with Upson Regional Medical Center, and maintains a secondary practice location in Warner Robins.

NPPES Registry Identity

NPI1457373565

Entity TypeIndividualFemale

Primary Taxonomy207RE0101X

Provider Legal NameASHWINI PRABHAKAR GORECredential: M.D.

Location Address235 SHERATON BLVDMacon, GA 31210-1359

Mailing Address235 Sheraton BlvdMacon, GA 31210-1359 · (478) 746-8626 · Fax (478) 746-0491

Phone(478) 746-8626

Fax(478) 746-0491

Sole ProprietorNo

Medical School CMSOtherGraduated 2001

Enumeration DateJuly 25, 2006

Last NPPES UpdateSeptember 4, 20262 updates tracked since enumeration

NPPES CertifiedSeptember 4, 2026

✔ NPI 1457373565 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians

Taxonomy Code207RE0101X

License✔ Licensed in GA · 65775

Definition

An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

Also ListedPreventive Medicine · Obesity MedicineTaxonomy 2083B0002X · License 65775 (GA)

235 SHERATON BLVD, Macon, GA 31210

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Secondary Practice Location 1

Location 1233 N Houston RdWarner Robins, GA 31093-3074 · Phone (478) 746-8626

Other Identifiers 2

Other2859838000PA · Bcbs

Other2088939PA · Highmark Blue Shield

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health 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

Ashwini Prabhakar Gore 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 ID5395742001

PECOS Enrollment IDI20110912000127

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 28

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.

563 services434 patients

Blood test, thyroid stimulating hormone (tsh) 84443

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

377 services253 patients

Uric acid level, blood 84550

A blood uric acid level test measures the amount of uric acid in your blood. Uric acid is a waste product that your body produces when it breaks down purines, substances found in your body and in certain foods. High levels may lead to gout or kidney stones.

337 services241 patients

Blood test, comprehensive group of blood chemicals 80053

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

325 services233 patients

Thyroxine (thyroid chemical), free 84439

The Thyroxine (thyroid chemical), free test is a blood test that measures the level of free T4 in your body. T4 is a hormone produced by your thyroid gland and is essential for growth and metabolism. If your T4 levels are too high or too low, it could indicate a thyroid disorder.

310 services206 patients

Thyroid hormone, t3 measurement, free 84481

The T3 measurement, free, is a blood test that checks the level of a hormone called triiodothyronine. This hormone is produced by your thyroid, a small gland in your neck. It plays a key role in regulating your body's metabolism and energy use.

265 services175 patients

Blood glucose (sugar) test performed by hand-held instrument 82962

A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.

197 services152 patients

Vitamin d-3 level 82306

A Vitamin D-3 level test measures the amount of Vitamin D-3, a crucial nutrient, in your body. This test helps identify if your levels are too low or too high. Low levels may lead to bone weakness, while high levels could harm your kidneys. It's a simple blood test.

185 services142 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

179 services132 patients

Blood test, lipids (cholesterol and triglycerides) 80061

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

173 services120 patients

Ultrasound scan of head and neck soft tissue 76536

An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.

159 services149 patients

Urine microalbumin (protein) level 82043

The urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.

144 services101 patients

Creatinine level to test for kidney function or muscle injury 82570

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

144 services101 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

116 services84 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

113 services97 patients

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251

This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.

81 services62 patients

Parathormone (parathyroid hormone) level 83970

The Parathormone level test measures the amount of parathyroid hormone in your blood. This hormone controls calcium and phosphorus levels in the body, which are vital for bone health. Abnormal levels may indicate issues like kidney disease or parathyroid gland disorders.

79 services60 patients

Cortisol (hormone) measurement, total 82533

Cortisol measurement is a test that checks the level of cortisol, a hormone, in your body. It's often used to assess stress levels or check for conditions like Addison's disease or Cushing's syndrome. This involves a simple blood or saliva sample.

59 services40 patients

Phosphate level 84100

A phosphate level test measures the amount of phosphate in your blood. Phosphate is a chemical that contains the mineral phosphorus, crucial for energy production, muscle and nerve function, and bone growth. Imbalances may indicate kidney disease or other health issues.

49 services36 patients

Magnesium level 83735

A magnesium level test is a simple blood test that measures the amount of magnesium in your body. Magnesium is a crucial mineral that helps your nerves, muscles, and heart function properly. The test can help detect health conditions like kidney disease or malnutrition.

44 services35 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

37 services36 patients

Cyanocobalamin (vitamin b-12) level 82607

A Cyanocobalamin (Vitamin B-12) level test is a blood test that checks the amount of Vitamin B-12 in your body. This vitamin is vital for nerve function and the creation of red blood cells. Low or high levels could indicate a potential health issue.

31 services27 patients

Prolactin (milk producing hormone) level 84146

A prolactin level test measures the amount of a hormone, prolactin, in your blood. This hormone plays a role in many bodily functions, such as the creation of milk. High or low levels can indicate certain health conditions. The test involves a simple blood draw.

23 services17 patients

Removal of fingernails or toenails, 6 or more nails 11721

This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.

20 services16 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.

20 services20 patients

Microsomal antibodies (autoantibody) measurement 86376

Microsomal antibodies measurement is a blood test to detect specific antibodies that your immune system may produce. It's often used to diagnose autoimmune conditions like thyroid disorders. The test is simple, involving a standard blood draw.

18 services16 patients

Gonadotropin, follicle stimulating (reproductive hormone) level 83001

This is a test that measures the level of a hormone in your body known as follicle stimulating hormone (FSH). FSH plays a key role in the body's reproductive processes. It's important for growth and the healthy functioning of the body.

15 services12 patients

Gonadotropin, luteinizing (reproductive hormone) level 83002

This is a blood test that measures the level of luteinizing hormone (LH). LH plays a key role in body growth and development. It's important for the proper functioning of certain glands. Irregular levels can indicate potential health issues.

14 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Upson Regional Medical Center

Acute Care Hospitals · Thomaston, GA

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110002

Location801 W Gordon StreetThomaston, GA 30286 · Upson County

Emergency services Birthing friendly

Houston Healthcare

Acute Care Hospitals · Warner Robins, GA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110069

Location1601 Watson BoulevardWarner Robins, GA 31093 · Houston County

Emergency services Birthing friendly

Atrium Health Navicent The Medical Center

Acute Care Hospitals · Macon, GA

1/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110107

Location777 Hemlock StreetMacon, GA 31201 · Bibb County

Emergency services Birthing friendly

Fairview Park Hospital

Acute Care Hospitals · Dublin, GA

5/5 CMS rating

OwnershipProprietary

CMS Certification Number110125

Location200 Industrial BoulevardDublin, GA 31021 · Laurens County

Emergency services Birthing friendly

Coliseum Medical Centers, LLC, Dba

Acute Care Hospitals · Macon, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110164

Location350 Hospital DriveMacon, GA 31217 · Bibb County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31210 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

$124.10 typical visit price

range $53.31 – $164.04

Typical copayment $31.02 (range $13.32 – $41.01)

Most-billed visit code 99204

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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.

38.36/100

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

Individually scored

Quality

26.37

Improvement Activities

Cost

92.71

Referred Medical Equipment & Supplies CMS DME claims 10

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

Supplies for maintenance of insulin infusion catheter, per week A4224

DME-Other DME · category DE017N

7 suppliers50 claims685 services$18.46 avg. paid by Medicare

Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225

DME-Other DME · category DE017N

6 suppliers47 claims1,515 services$2.38 avg. paid by Medicare

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

39 suppliers98 claims356 services$6.48 avg. paid by Medicare

Normal, low and high calibrator solution / chips A4256

DME-Other DME · category DE000N

3 suppliers12 claims12 services$2.92 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

22 suppliers46 claims69 services$1.10 avg. paid by Medicare

For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe A5500

DME-Orthotic Devices · category DF000N

3 suppliers12 claims24 services$61.47 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Ashwini Gore's NPI number?

The NPI number for Ashwini Gore is 1457373565. It was assigned to this individual provider in the NPPES registry on July 25, 2006.

Where is Ashwini Gore located?

Ashwini Gore practices at 235 Sheraton Blvd, Macon, GA 31210. The listed phone number is (478) 746-8626.

What is Ashwini Gore's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Ashwini Gore enrolled in Medicare?

Yes. Ashwini Gore 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 Ashwini Gore accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Ashwini Gore 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 Ashwini Gore affiliated with any hospitals?

According to CMS data, Ashwini Gore is affiliated with Upson Regional Medical Center, Houston Healthcare, Atrium Health Navicent The Medical Center, Fairview Park Hospital and Coliseum Medical Centers, LLC, Dba.

When was this NPI record last updated?

The NPPES record for Ashwini Gore was last updated on September 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 days 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.