NPI registry status
Active
2026 NPPES data Gastroenterology Physician NPI 1528098118 M.D.
Verify on CMS → Carl Guillaume, M.D.
Gastroenterology Physician in Bronx, New York.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 16,567 in Gastroenterology Physician, and covers specialty classification, practice address, and Medicare Part D prescribing data when reported. According to CMS, every field reflects the provider's official federal registration, see our methodology.
Federal data, no proprietary rating.
We show these CMS records as-is - no composite score, no star rating, no editorial opinion layered on top.
Prescribing volume
955
Medicare Part D claims · 210 beneficiaries · Gastroenterology Physician avg: 833
Generic prescribing
77%
generic claims · 23% brand-name · higher generic rates reduce patient out-of-pocket costs
Industry payments
$94.24
4 payments · CMS Open Payments (Sunshine Act)
Source: CMS Medicare Part D Prescriber Public Use File, 2023
Compiled from official public sources by the PlainDoctor editorial team.
What the federal data shows
Carl Guillaume, M.D. filed 955 Medicare Part D claims in 2023 as a Gastroenterology Physician in Bronx, New York, prescribing 77% generic.
- 955
- Part D claims, 2023
- 77%
- generic prescribing
- Likely
- board-certified (heuristic)
Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) - no proprietary rating or editorial opinion is applied.
Carl Guillaume, M.D.'s Medicare Part D volume vs every U.S. prescriber
Total Medicare Part D claims, 2023, across all CMS prescribers nationally
955 Top 25% higher than 75% of 1,370,886 prescribers
Each bar is a band; taller bars hold more prescribers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
Source CMS Medicare Part D Prescriber Public Use File · 2023
✓
Board certification likely (heuristic, not verified)
Carl Guillaume, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + 2 hospital affiliations - signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).
What does the federal data show about Carl Guillaume, M.D.?
Quality data not reportedPrimary specialty
Gastroenterology Physician
Medicare Part D claims
955 15% vs specialty avg
Specialty distribution in New York
How Gastroenterology Physician compares to other specialties among New York providers
Board certification
Not published by CMS
CMS does not publish a per-provider board-certification field in NPPES. PlainDoctor does not have a reliable per-specialty certification rate to show for Gastroenterology Physician. Verify directly:
How MIPS and board certification work
The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).
Carl Guillaume, M.D. appears in the CMS NPPES registry as a Gastroenterology Physician provider holding M.D. credentials at 4422 3RD AVE, Bronx, NY, 10457, with a listed phone of (718) 960-6205. NPI 1528098118 was issued on 07/03/2006.
Medicare Part D records for calendar year 2023 show 955 prescription claims written by this provider, covering 210 Medicare beneficiaries and totaling roughly $281K in drug spend, split 23% brand-name and 77% generic by claim count.
Gastroenterology Physician is a mid-sized specialty nationwide, with 16,567 enrolled providers across 54 states and an average of 833 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline.
Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist, always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.
Practice Address
Provider Details
| NPI | 1528098118 |
|---|---|
| Specialty | Gastroenterology Physician |
| Credentials | M.D. |
| Gender | Male |
| NPI Issued | 07/03/2006 |
Hospital and facility affiliations
Facilities where Carl Guillaume, M.D. bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" - a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.
Medical Associates, P.C.
Elmhurst, NY
Morris Heights Health Center, Inc.
Bronx, NY
Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).
Industry payments received (2024) - CMS Open Payments transparency data
The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for Carl Guillaume, M.D.. Source: openpaymentsdata.cms.gov.
Total received
$94
Largest payer
Boston Scientific Corporation
Most common payment type
Food and Beverage
Industry payments are not necessarily indicators of bias, they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.
License & disciplinary context - New York NYSBPMC 2023 annual report
Aggregate state board data only, NOT a determination of any individual provider's status. The figures below describe statewide disciplinary activity across all ~100K New York medical licensees in 2023 - they are NOT specific to Carl Guillaume, M.D.. To verify Carl Guillaume, M.D.'s current license status, search the NYSBPMC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.
312
Total board actions, New York 2023
Across 302 cases
3.12
Actions per 1,000 licensees
New York statewide rate
probation
Most common action type
89 cases
NYSBPMC publishes annual disciplinary statistics as part of public-record reporting under each state's Administrative Procedure Act. See the full breakdown by action type and year on the New York disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.
Brand vs generic prescribing mix · Typical
Carl Guillaume, M.D. - brand share 23.0%
Gastroenterology Physician average
23% brand-name claims vs 77% generic, on 955 2023 Medicare Part D claims.
The federal Medicare Part D Generic Dispensing Rate national benchmark sits near 90% generic / 10% brand for primary-care prescribers, per CMS Office of the Actuary 2024 estimates. Higher brand share is common in specialty prescribing where generic equivalents are not available.
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
955
Total Claims
$281K
Total Drug Cost
210
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 1,839
- Total Day Supply
- 53,836
- Brand vs Generic
- 23% brand / 77% generic
- Brand Drug Cost
- $251K
- Generic Drug Cost
- $30K
- Antibiotic Claims
- 17
Patient Demographics
- Average Patient Age
- 71.3 years
- Avg HCC Risk Score
- 1.06
- Gender Split
- 62% female / 38% male
- Age Distribution
- <65: 30, 65-74: 109, 75-84: 58, 85+: 13
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Carl Guillaume, M.D. prescribes most
Top Medicare Part D drugs by claim count, 2023
- Famotidine
Famotidine
340 claims
- Omeprazole
Omeprazole
222 claims
- Linzess
Linzess
180 claims
- Pantoprazole Sodium 23
Pantoprazole Sodium
23 claims
- Ondansetron Hcl 14
Ondansetron Hcl
14 claims
- Procto-Med Hc 13
Procto-Med Hc
13 claims
- Hydrocortisone 12
Hydrocortisone
12 claims
- Omeprazole-Sodium … 12
Omeprazole-Sodium Bicarbonate
12 claims
| Drug | Claims |
|---|---|
| Famotidine | 340 |
| Omeprazole | 222 |
| Linzess Linaclotide | 180 |
| Pantoprazole Sodium | 23 |
| Ondansetron Hcl | 14 |
| Procto-Med Hc Hydrocortisone | 13 |
| Hydrocortisone | 12 |
| Omeprazole-Sodium Bicarbonate Omeprazole/Sodium Bicarbonate | 12 |
| Amoxicillin | 11 |
| Dexlansoprazole Dr Dexlansoprazole | 11 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Gastroenterology Physician Overview
How Carl Guillaume, M.D. fits within the Gastroenterology Physician landscape nationally.
16,567
Gastroenterology Physician Providers in US
54
States with Gastroenterology Physician
833
Avg Claims per Provider
Carl Guillaume, M.D.'s 955 claims are above the specialty average of 833.
Nearby Gastroenterology Physician Providers in New York
Other clinicians with the same primary specialty enrolled in New York, drawn from the same CMS NPPES roster as Guillaume.
Dr. Elie Abadie
MD
Brooklyn, NY
Dr. Hafsa Abbas
MD
Flushing, NY
Dr. Naeem Abbas
MD
Valley Stream, NY
Dr. Uzma Abbasi
M.D.
Oneida, NY
Amro Abdellatief
New York, NY
Compare Gastroenterology Physician nationally: see state-by-state distribution →
Before you book an appointment
Use this federal record as your verification checklist, not as a recommendation.
- Confirm the NPI record is current in the official CMS registry, providers update their own NPPES details, and moves can lag. Verify this NPI
- Check the active license and any disciplinary history with the New York medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Gastroenterology Physician peer on Medicare volume and prescribing patterns. Compare providers
Medicare Part D and MIPS figures describe practice patterns in federal programs only, they are not quality ratings, and PlainDoctor does not rate, rank, or recommend providers.
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Frequently Asked Questions
What is Carl Guillaume, M.D.'s specialty? ▼
Carl Guillaume, M.D. specializes in Gastroenterology Physician and practices in Bronx, New York. Credentials: M.D..
How much does Carl Guillaume, M.D. prescribe under Medicare Part D? ▼
In 2023, Carl Guillaume, M.D. wrote 955 Medicare Part D claims totaling $281K in drug costs for 210 beneficiaries.
Where is Carl Guillaume, M.D. located? ▼
Carl Guillaume, M.D. is located at 4422 3RD AVE, Bronx, NY, 10457. Phone: (718) 960-6205.
What is Carl Guillaume, M.D.'s NPI number? ▼
Carl Guillaume, M.D.'s National Provider Identifier (NPI) is 1528098118, issued on 07/03/2006.
Does Carl Guillaume, M.D. prescribe more brand-name or generic drugs? ▼
Carl Guillaume, M.D.'s prescribing is 23% brand-name and 77% generic drugs by claim count, with $251K in brand drug costs.
How many Gastroenterology Physician providers are there in the US? ▼
There are 16,567 Gastroenterology Physician providers across 54 states in the US. The average Gastroenterology Physician provider writes 833 Medicare Part D claims per year.
What drugs does Carl Guillaume, M.D. prescribe most often? ▼
Based on 2023 Medicare Part D data, Carl Guillaume, M.D.'s most frequently prescribed drugs include Famotidine, Omeprazole, Linzess. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Carl Guillaume, M.D. accept Medicare? ▼
Carl Guillaume, M.D. appears in CMS Medicare data with 955 Part D claims and 210 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Carl Guillaume, M.D.'s credentials? ▼
Carl Guillaume, M.D.'s NPI is 1528098118 with credentials M.D.. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.
Data Sources
View source datasets and methodology notes
- Provider Directory
- CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
- Specialty Classification
- NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
- Prescribing Data
- CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
- Limitations
- Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.
See our complete data methodology for details on how we collect and process government data.
Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).
Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology
Compiled from official public sources by the PlainDoctor editorial team.