Active NPI 1770566242 Individual Practitioner Male Practitioner

Dr. James A Gilbert , MD

Internal Medicine • Sutton, MA

Professional Overview & Biography Verified Profile Summary

Dr. James Gilbert, MD is a registered healthcare professional specializing in Internal Medicine in Sutton, MA. Practice services are available at 188 WORCESTER PROVIDENCE TPKE under active NPI credentials.

Frequently performed procedures and clinical services include established patient outpatient office visit, vaccine for influenza for administration into muscle, 0.5 ml dosage, administration of influenza virus vaccine. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

188 Worcester Providence Tpke

Sutton, MA 015901908

Telephone 5088653650

Associated Practice Facility / Clinic

🏢 Umass Memorial Medical Group Inc Facility NPI 1760445373

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Sutton, MA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 29.7 Yrs

State Avg: 29.3 Yrs

Regional Practice Density

4 Specialists

Practicing in Sutton, MA (7127 Statewide)

Telehealth Adoption Rate

75.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

62.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	85	83	$306.35	$113.84

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	356	173	$296.00	$111.98
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	76	74	$38.00	$17.25
G0008 Administration of influenza virus vaccine	75	73	$69.00	$23.21
99213 Established patient office or other outpatient visit, typically 15 minutes	69	51	$199.00	$75.76
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	21	21	$348.00	$122.09
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	19	16	$214.00	$56.32
G0009 Administration of pneumococcal vaccine	15	15	$69.00	$23.21
90670 Pneumococcal vaccine for injection into muscle	14	14	$392.00	$184.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	353	166	$296.00	$111.20
99213 Established patient office or other outpatient visit, typically 15 minutes	88	60	$199.00	$74.94
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	71	71	$38.00	$17.48
G0008 Administration of influenza virus vaccine	68	68	$69.00	$28.66
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	25	23	$214.00	$55.73
G0009 Administration of pneumococcal vaccine	17	17	$69.00	$28.66
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	14	14	$348.00	$119.76

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License MA 43094

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

2072025 (MA)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners

Dr. Rebecca Kasenge , DO

Internal Medicine

NPI 1629121660

Doctor of Osteopathic Medicine (D.O.)

Dr. Abdulraouf Ghandour , MD

Family Medicine

NPI 1629276803

Doctor of Medicine (M.D.)

Dr. Mary Gulla , MD

Internal Medicine

NPI 1902869571

Doctor of Medicine (M.D.)

Dr. Herath Wijerathna , MD

Internal Medicine

NPI 1912232307

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active October 08, 2014

NPI status registered as active in NPPES database

📍

Updated Practice Location October 08, 2014

Registered at 188 WORCESTER PROVIDENCE TPKE, SUTTON, MA 015901908 (Tel: 5088653650)

📍

Updated Business Mailing Address October 08, 2014

Registered at PO BOX 415348, BOSTON, MA 022415348

👤

Provider Name / Credentials Updated October 08, 2014

Recorded as JAMES GILBERT, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 08, 2014

Internal Medicine (License #43094 in MA)

🟢

Initial NPI Registration & Enumeration November 29, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1770566242

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: November 29, 2005

Last Update: October 08, 2014

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 415348

Boston, MA 022415348

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.