MADHAVI GADDAM M.D.
NPI 1710198544
Internal Medicine - Endocrinology, Diabetes & Metabolism in Denton, TX

Active since May 24, 2007PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
3300 COLORADO BLVD, DENTON, TX 76210(940) 488-4767(855) 444-9702 Get Directions Write a Review

NPPES record last updated: August 1, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Madhavi Gaddam M.d. NPPES

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

MADHAVI GADDAM M.D. (NPI 1710198544) is an individual endocrinology, diabetes & metabolism provider in Denton, Texas, licensed in Texas (N3040) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS, is affiliated with Medical City Denton, and is a graduate of Other (1999).

NPPES Registry Identity

NPI1710198544
Entity TypeIndividualFemale
Primary Taxonomy207RE0101X
Provider Legal NameMADHAVI GADDAMCredential: M.D.
Location Address3300 COLORADO BLVDDenton, TX 76210
Mailing Address2245 Brinker RdDenton, TX 76208-6175 · (940) 488-4767 · Fax (877) 795-8358
Fax(855) 444-9702
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateMay 24, 2007
Last NPPES UpdateAugust 1, 2018
NPI 1710198544 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 TX · N3040
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 MD27194 (OR)
3300 COLORADO BLVD, Denton, TX 76210

Other Identifiers 5

Medicaid205024702TX
Medicaid205024703TX
OtherP00691956TX · Railroad Medicare Number
Medicaid205024701TX
OtherP00838701TX · Railroad Medicare

Accepted 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

Madhavi Gaddam 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 ID3375697865
PECOS Enrollment IDI20090818000614
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 9

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.
920 services423 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.
355 services126 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.
94 services74 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.
57 services57 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
45 services22 patients
Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) G0506
This service involves a thorough evaluation of patients needing ongoing care for chronic conditions. It includes creating a tailored care plan, coordinating with healthcare providers, and monitoring progress regularly. The goal is to provide optimal, personalized care for your long-term health needs.
25 services25 patients

Hospital Affiliations CMS Care Compare 4

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

Medical City Denton

Acute Care Hospitals · Denton, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number450634
Location3535 South I35 EastDenton, TX 76210 · Denton County
Emergency services

Medical City Plano

Acute Care Hospitals · Plano, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450651
Location3901 W 15th StPlano, TX 75075 · Collin County
Emergency services Birthing friendly

Texas Health Presbyterian Hospital Denton

Acute Care Hospitals · Denton, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450743
Location3000 N I-35Denton, TX 76201 · Denton County
Emergency services Birthing friendly

Texas Health Presbyterian Hospital Plano

Acute Care Hospitals · Plano, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450771
Location6200 W Parker RdPlano, TX 75093 · Collin County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76210 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
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.

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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Reported Quality Measures

Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy - Neurological Evaluation
Percentage of patients aged 18 years and older with a diagnosis of diabetes mellitus who had a neurological examination of their lower extremities within 12 months
0%928 patients1/55-star benchmark: 100%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
17%820 patients1/55-star benchmark: 100%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
71%820 patients3/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%3,907 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
47%2,179 patients2/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
0%527 patients1/55-star benchmark: 98%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
24%1,691 patients1/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
93%931 patients4/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
1%291 patients1/55-star benchmark: 97%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
52%931 patients3/55-star benchmark: 79%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 8

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
10 suppliers36 claims434 services$17.79 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
10 suppliers38 claims1,163 services$2.22 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 suppliers69 claims232 services$5.99 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
11 suppliers30 claims44 services$1.14 avg. paid by Medicare
External ambulatory infusion pump, insulin E0784
DME-Other DME · category DE017N
6 suppliers45 claims45 services$300.72 avg. paid by Medicare
Insulin for administration through dme (i.e., insulin pump) per 50 units J1817
Treatment-Injections and Infusions (nononcologic) · category RI000N
10 suppliers27 claims3,490 services$7.07 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 6

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

Internal Medicine (Endocrinology, Diabetes & Metabolism)
3300 COLORADO BLVD
DENTON, TX 76210
Specialist
3300 COLORADO BLVD
DENTON, TX 76210
Specialist
3300 COLORADO BLVD
DENTON, TX 76210
Internal Medicine (Endocrinology, Diabetes & Metabolism)
3300 COLORADO BLVD
DENTON, TX 76210
Clinic/Center (Sleep Disorder Diagnostic)
3300 COLORADO BLVD
DENTON, TX 76210
Internal Medicine (Rheumatology)
3300 COLORADO BLVD
DENTON, TX 76210

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 Madhavi Gaddam's NPI number?

The NPI number for Madhavi Gaddam is 1710198544. It was assigned to this individual provider in the NPPES registry on May 24, 2007.

Where is Madhavi Gaddam located?

Madhavi Gaddam practices at 3300 Colorado Blvd, Denton, TX 76210. The listed phone number is (940) 488-4767.

What is Madhavi Gaddam's specialty?

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

Is Madhavi Gaddam enrolled in Medicare?

Yes. Madhavi Gaddam 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 Madhavi Gaddam accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 3 other insurers list Madhavi Gaddam 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 Madhavi Gaddam affiliated with any hospitals?

According to CMS data, Madhavi Gaddam is affiliated with Medical City Denton, Medical City Plano, Texas Health Presbyterian Hospital Denton and Texas Health Presbyterian Hospital Plano.

When was this NPI record last updated?

The NPPES record for Madhavi Gaddam was last updated on August 1, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.