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GAURAV BHALLA M.D.
NPI 1457616120
Internal Medicine - Endocrinology, Diabetes & Metabolism in Fort Gratiot, MI

Active since July 09, 2012PECOS EnrolledAccepts Medicare Assignment
90.52/100
CMS Quality Rating
4190 24TH AVE STE 201, FORT GRATIOT, MI 48059(810) 216-4200 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jul 21, 2022, Aug 17, 2017 (2 updates tracked since 2017).

About Gaurav Bhalla M.d. NPPES

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

GAURAV BHALLA M.D. (NPI 1457616120) is an individual endocrinology, diabetes & metabolism provider in Fort Gratiot, Michigan, licensed in Michigan (4301100838) and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS, is affiliated with Lake Huron Medical Center, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1457616120
Entity TypeIndividualMale
Primary Taxonomy207RE0101X
Provider Legal NameGAURAV BHALLACredential: M.D.
Location Address4190 24TH AVE STE 201Fort Gratiot, MI 48059-3884
Mailing Address4190 24th Ave Ste 201Fort Gratiot, MI 48059-3884 · (810) 216-4200
Phone(810) 216-4200
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateJuly 9, 2012
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1457616120 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 MI · 4301100838
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 ListedInternal MedicineTaxonomy 207R00000X · License 4301100838 (MI)
4190 24TH AVE STE 201, Fort Gratiot, MI 48059
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community 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

Gaurav Bhalla 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 ID244505170
PECOS Enrollment IDI20171003006805
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 10

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.
467 services292 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.
141 services79 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.
126 services100 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.
98 services24 patients
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211
This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.
59 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.
56 services56 patients

Hospital Affiliations CMS Care Compare 5

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

Lake Huron Medical Center

Acute Care Hospitals · Port Huron, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230031
Location2601 Electric AvenuePort Huron, MI 48060 · St. Clair County
Emergency services

Mclaren Port Huron

Acute Care Hospitals · Port Huron, MI
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230216
Location1221 Pine Grove AvePort Huron, MI 48060 · St. Clair County
Emergency services Birthing friendly

Deckerville Community Hospital

Critical Access Hospitals · Deckerville, MI
OwnershipVoluntary non-profit - Private
CMS Certification Number231311
Location3559 Pine StDeckerville, MI 48427 · Sanilac County
Emergency services

Harbor Beach Community Hospital

Critical Access Hospitals · Harbor Beach, MI
OwnershipVoluntary non-profit - Private
CMS Certification Number231313
Location210 S First StHarbor Beach, MI 48441 · Huron County
Emergency services

Mckenzie Health System

Critical Access Hospitals · Sandusky, MI
OwnershipVoluntary non-profit - Private
CMS Certification Number231314
Location120 N Delaware StreetSandusky, MI 48471 · Sanilac County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48059 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
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

90.52/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40
Cost54.15

Referred Medical Equipment & Supplies CMS DME claims 9

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
5 suppliers54 claims627 services$18.36 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
5 suppliers51 claims1,531 services$2.33 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
25 suppliers91 claims353 services$5.87 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
3 suppliers11 claims11 services$2.12 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
13 suppliers37 claims70 services$0.97 avg. paid by Medicare
External ambulatory infusion pump, insulin E0784
DME-Other DME · category DE017N
3 suppliers25 claims25 services$286.03 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 Gaurav Bhalla's NPI number?

The NPI number for Gaurav Bhalla is 1457616120. It was assigned to this individual provider in the NPPES registry on July 9, 2012.

Where is Gaurav Bhalla located?

Gaurav Bhalla practices at 4190 24th Ave Ste 201, Fort Gratiot, MI 48059. The listed phone number is (810) 216-4200.

What is Gaurav Bhalla's specialty?

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

Is Gaurav Bhalla enrolled in Medicare?

Yes. Gaurav Bhalla 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 Gaurav Bhalla accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list Gaurav Bhalla 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 Gaurav Bhalla affiliated with any hospitals?

According to CMS data, Gaurav Bhalla is affiliated with Lake Huron Medical Center, Mclaren Port Huron, Deckerville Community Hospital, Harbor Beach Community Hospital and Mckenzie Health System.

When was this NPI record last updated?

The NPPES record for Gaurav Bhalla was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.