CLAUDIU G GHERLAN MD
NPI 1639134216
Internal Medicine in Madison, WI

Q: What is Claudiu Gherlan's NPI number?

The NPI number for Claudiu Gherlan is 1639134216. It was assigned to this individual provider in the NPPES registry on April 18, 2006.

Q: What is Claudiu Gherlan's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Claudiu Gherlan was last updated on October 25, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since April 18, 2006PECOS EnrolledAccepts Medicare Assignment

80.22/100

CMS Quality Rating

8202 EXCELSIOR DR, MADISON, WI 53717(608) 831-1766(608) 662-4185 Get Directions Write a Review

NPPES record last updated: October 25, 2012. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Claudiu G Gherlan Md NPPES

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

CLAUDIU G GHERLAN MD (NPI 1639134216) is an individual internal medicine provider in Madison, Wisconsin, licensed in Wisconsin (45470-020) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Unitypoint Health - Meriter, and is a graduate of Other (1994).

NPPES Registry Identity

NPI1639134216

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameCLAUDIU G GHERLANCredential: MD

Location Address8202 EXCELSIOR DRMadison, WI 53717-1906

Mailing Address8202 Excelsior DrMadison, WI 53717-1906 · (608) 831-1766 · Fax (608) 662-4185

Phone(608) 831-1766

Fax(608) 662-4185

Sole ProprietorNo

Medical School CMSOtherGraduated 1994

Enumeration DateApril 18, 2006

Last NPPES UpdateOctober 25, 2012

✔ NPI 1639134216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in WI · 45470-020

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

8202 EXCELSIOR DR, Madison, WI 53717

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Other Identifiers 4

Medicare ID-Type UnspecifiedP00026658WI · Railroad Medicare

Medicaid34384000WI

Medicare PIN006757155WI

Medicare UPINH85536

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Group Health Cooperative-SCW, HealthPartners 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

Claudiu G Gherlan 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.

PECOS PAC ID547282907

PECOS Enrollment IDI20051228000645

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

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

Group Health Cooperative Of South Central Wisconsin

0.5 mi

Health Maintenance Organization

1265 JOHN Q HAMMONS DR
Madison, WI 53717

Reassigned Medicare billing, Wisconsin enrollment
422 clinicians in this Medicare group

NPI 1245260165 (608) 251-4156

Meriter Hospital, Inc.

6.3 mi

Psychiatric Unit

202 S PARK ST
Madison, WI 53715

Reassigned Medicare billing, Wisconsin enrollment
164 clinicians in this Medicare group

NPI 1548280225 (608) 417-6000

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 15

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 low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

163 services138 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.

159 services107 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.

104 services77 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

69 services69 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.

42 services40 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.

25 services25 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.

25 services25 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.

24 services11 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.

23 services19 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.

22 services22 patients

Blood test, basic group of blood chemicals (calcium, total) 80048

A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.

19 services15 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

17 services16 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

16 services15 patients

Prostate cancer screening; prostate specific antigen test (psa) G0103

Prostate cancer screening involves a simple blood test known as the Prostate Specific Antigen (PSA) test. This test measures the level of PSA in your blood. Higher than normal levels can be an early indication of prostate issues, including cancer. It's a key tool in early detection.

13 services13 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

13 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Unitypoint Health - Meriter

Acute Care Hospitals · Madison, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520089

Location202 S Park StMadison, WI 53715 · Dane County

Emergency services Birthing friendly

University Of Wi Hospitals & Clinics Authority

Acute Care Hospitals · Madison, WI

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number520098

Location600 Highland AvenueMadison, WI 53792 · Dane County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53717 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.

80.22/100

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

Scored as part of a group practice

Quality

85.06

Promoting Interoperability

Improvement Activities

Cost

49.83

Referred Medical Equipment & Supplies CMS DME claims 16

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

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

DME-Other DME · category DE017N

19 suppliers75 claims302 services$5.38 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

10 suppliers23 claims38 services$0.83 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

2 suppliers33 claims33 services$36.81 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

3 suppliers22 claims129 services$15.20 avg. paid by Medicare

Pillow for use on nasal cannula type interface, replacement only, pair A7033

DME-Other DME · category DE001N

2 suppliers15 claims85 services$13.59 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

4 suppliers43 claims43 services$53.02 avg. paid by Medicare

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

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.

GHADEER ALAFIFI

Specialist