2026 NPPES data Rheumatology Physician NPI 1679861702 M.D
Verify on CMS →

Carla Gamarra-Hilburn, M.D

Rheumatology Physician in New Albany, Indiana. This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 6,181 in Rheumatology 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
2K
Medicare Part D claims · 243 beneficiaries · Rheumatology Physician avg: 2K
Generic prescribing
90%
generic claims · 9% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
97.5/100
▲ 14 pts above national avg 83.1 · Exceptional
Industry payments
$588.58
30 payments · CMS Open Payments (Sunshine Act)
Compiled from official public sources by the PlainDoctor editorial team.

What the federal data shows

Carla Gamarra-Hilburn, M.D reported a CMS MIPS final score of 97.5/100 - above the 83.1 national average - and filed 2,037 Medicare Part D claims in 2023.

97.5/100
MIPS score · +14 vs avg
2K
Part D claims, 2023
90%
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.

Carla Gamarra-Hilburn, M.D's MIPS score vs every scored U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure

98 Top 15% higher than 85% of 477,587 scored providers

0–10: 8,684 scored providers (2%). Below this entry. 10–20: 3,008 scored providers (1%). Below this entry. 20–30: 3,069 scored providers (1%). Below this entry. 30–40: 2,746 scored providers (1%). Below this entry. 40–50: 2,928 scored providers (1%). Below this entry. 50–60: 5,882 scored providers (1%). Below this entry. 60–70: 13,906 scored providers (3%). Below this entry. 70–80: 118,074 scored providers (25%). Below this entry. 80–90: 129,887 scored providers (27%). Below this entry. 90+: 189,403 scored providers (40%). This entry sits in this band. This provider 0 100 every MIPS-scored clinician, bucketed by value

Each bar is a band; taller bars hold more scored providers. 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 Merit-based Incentive Payment System (MIPS) · 2023

Where Carla Gamarra-Hilburn, M.D sits

This provider among rheumatology physician peers

Across the 2,181 rheumatology physician providers who report both Medicare Part D prescribing and a MIPS quality score, Carla Gamarra-Hilburn, M.D writes more Part D claims than 53% of them and scores higher on MIPS quality than 87% - placing this provider in the high-volume, high-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.

Part D claim volume vs MIPS quality, by specialty percentile

Lower volume · High qualityHigh volume · High qualityLower volume · Lower qualityHigh volume · Lower quality0255075100024.949.974.899.8Part D claim volume, percentile in specialtyMIPS quality, percentilePart D claim volume, percentile in specialty: 22 · MIPS quality, percentile: 23Part D claim volume, percentile in specialty: 25 · MIPS quality, percentile: 20Part D claim volume, percentile in specialty: 28 · MIPS quality, percentile: 30Part D claim volume, percentile in specialty: 78 · MIPS quality, percentile: 22Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 95Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 90Part D claim volume, percentile in specialty: 8 · MIPS quality, percentile: 50Part D claim volume, percentile in specialty: 12 · MIPS quality, percentile: 83Part D claim volume, percentile in specialty: 90 · MIPS quality, percentile: 32Part D claim volume, percentile in specialty: 73 · MIPS quality, percentile: 90Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 28Part D claim volume, percentile in specialty: 13 · MIPS quality, percentile: 55Part D claim volume, percentile in specialty: 93 · MIPS quality, percentile: 8Part D claim volume, percentile in specialty: 63 · MIPS quality, percentile: 73Part D claim volume, percentile in specialty: 98 · MIPS quality, percentile: 8Part D claim volume, percentile in specialty: 43 · MIPS quality, percentile: 80Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 43Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 62Part D claim volume, percentile in specialty: 68 · MIPS quality, percentile: 18Part D claim volume, percentile in specialty: 72 · MIPS quality, percentile: 8Part D claim volume, percentile in specialty: 50 · MIPS quality, percentile: 67Part D claim volume, percentile in specialty: 38 · MIPS quality, percentile: 90Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 95Part D claim volume, percentile in specialty: 88 · MIPS quality, percentile: 58Part D claim volume, percentile in specialty: 92 · MIPS quality, percentile: 47Part D claim volume, percentile in specialty: 10 · MIPS quality, percentile: 37Part D claim volume, percentile in specialty: 0 · MIPS quality, percentile: 0Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 62Part D claim volume, percentile in specialty: 52 · MIPS quality, percentile: 40Part D claim volume, percentile in specialty: 77 · MIPS quality, percentile: 95Part D claim volume, percentile in specialty: 33 · MIPS quality, percentile: 62Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 27Part D claim volume, percentile in specialty: 87 · MIPS quality, percentile: 5Part D claim volume, percentile in specialty: 82 · MIPS quality, percentile: 8Part D claim volume, percentile in specialty: 100 · MIPS quality, percentile: 57Part D claim volume, percentile in specialty: 83 · MIPS quality, percentile: 32Part D claim volume, percentile in specialty: 3 · MIPS quality, percentile: 50Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 48Part D claim volume, percentile in specialty: 15 · MIPS quality, percentile: 25Part D claim volume, percentile in specialty: 23 · MIPS quality, percentile: 8Part D claim volume, percentile in specialty: 70 · MIPS quality, percentile: 87Part D claim volume, percentile in specialty: 58 · MIPS quality, percentile: 82Part D claim volume, percentile in specialty: 55 · MIPS quality, percentile: 60Part D claim volume, percentile in specialty: 60 · MIPS quality, percentile: 2Part D claim volume, percentile in specialty: 80 · MIPS quality, percentile: 3Part D claim volume, percentile in specialty: 45 · MIPS quality, percentile: 75Part D claim volume, percentile in specialty: 65 · MIPS quality, percentile: 45Part D claim volume, percentile in specialty: 85 · MIPS quality, percentile: 38Part D claim volume, percentile in specialty: 48 · MIPS quality, percentile: 95Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 78Part D claim volume, percentile in specialty: 20 · MIPS quality, percentile: 42Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 53Part D claim volume, percentile in specialty: 42 · MIPS quality, percentile: 35Part D claim volume, percentile in specialty: 75 · MIPS quality, percentile: 68Part D claim volume, percentile in specialty: 67 · MIPS quality, percentile: 8Part D claim volume, percentile in specialty: 5 · MIPS quality, percentile: 77Part D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 7Part D claim volume, percentile in specialty: 7 · MIPS quality, percentile: 85Part D claim volume, percentile in specialty: 40 · MIPS quality, percentile: 70Part D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 72Carla Gamarra-Hilburn, M.D-Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 87
Part D claim volume vs MIPS quality, by specialty percentile

Each dot is one rheumatology physician peer from a representative sample of 60; the gold marker is Carla Gamarra-Hilburn, M.D. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.

Board certification likely (heuristic, not verified)

Carla Gamarra-Hilburn, M.D practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 1 hospital affiliation - 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 Carla Gamarra-Hilburn, M.D?

High performer (top quartile)

NPI registry status

Active

Issued 07/11/2011

NPI 1679861702

Primary specialty

Rheumatology Physician

Mid-sized

6,181 US NPIs in this specialty

Medicare Part D claims

2,037 1% vs specialty avg

2023 prescription claims

Specialty avg: 2,054

MIPS final score

97.5/100 14.4 pts vs avg

Exceptional band

vs 83.1 national avg

Specialty distribution in Indiana

How Rheumatology Physician compares to other specialties among Indiana providers

Indiana providers

Largest specialties in Indiana (% of in-state providers)

Behavior Technician - 13.6%Behavior Technician13.6%Student in an Organized Health Care Education/Training Program - 4.7%Student in an Organized Health Care Education/Training Program4.7%Pharmacist - 4.3%Pharmacist4.3%Family Nurse Practitioner - 4.2%Family Nurse Practitioner4.2%Clinical Social Worker - 4.2%Clinical Social Worker4.2%Mental Health Counselor - 4.1%Mental Health Counselor4.1%Rheumatology Physician - 0.1%Rheumatology Physician0.1%
Largest specialties in Indiana (% of in-state providers)

Medicare quality performance, MIPS

Carla Gamarra-Hilburn, M.D's 2023 MIPS final score plotted against the Rheumatology Physician national average

High performer (top quartile)
MIPS Final Score
97.5/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Rheumatology Physician) - 97.5/100 vs national avg 83.1

0%100%National avg83%97.5%
MIPS final score (Rheumatology Physician) - 97.5/100 vs national avg 83.1

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).

Carla Gamarra-Hilburn, M.D appears in the CMS NPPES registry as a Rheumatology Physician provider holding M.D credentials at 1919 STATE ST STE 462, New Albany, IN, 47150, with a listed phone of (812) 725-0200. NPI 1679861702 was issued on 07/11/2011. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what Gamarra-Hilburn most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.

Medicare Part D records for calendar year 2023 show 2,037 prescription claims written by this provider, covering 243 Medicare beneficiaries and totaling roughly $736K in drug spend, split 9% brand-name and 90% generic by claim count. These figures capture only Medicare Part D, commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 97.5/100 for the 2023 performance year (Quality 95), compared with the national average of 83.1.

Rheumatology Physician is a mid-sized specialty nationwide, with 6,181 enrolled providers across 52 states and an average of 2,054 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

1919 STATE ST STE 462
New Albany, IN 47150

Provider Details

NPI 1679861702
Specialty Rheumatology Physician
Credentials M.D
Gender Female
NPI Issued 07/11/2011

CMS Quality Score (MIPS)

Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.

97.5
Final Score
Avg: 83.1
95
Quality

Reporting: Group practice

Hospital and facility affiliations

Facilities where Carla Gamarra-Hilburn, 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.

American Arthritis And Rheumatology Associates IN LLC
New Albany, IN

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 Carla Gamarra-Hilburn, M.D. Source: openpaymentsdata.cms.gov.

Total received

$589

Largest payer

ABBVIE INC.

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.

Brand vs generic prescribing mix · Generic-heavy

Carla Gamarra-Hilburn, M.D - brand share 9.0%
Rheumatology Physician average

9% brand-name claims vs 90% generic, on 2,037 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.

2,037
Total Claims
$736K
Total Drug Cost
243
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
2,714
Total Day Supply
77,994
Brand vs Generic
9% brand / 90% generic
Brand Drug Cost
$693K
Generic Drug Cost
$44K

Patient Demographics

Average Patient Age
69.9 years
Avg HCC Risk Score
1.28
Gender Split
66% female / 34% male

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.

What Carla Gamarra-Hilburn, M.D prescribes most

Top Medicare Part D drugs by claim count, 2023

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2023
Drug Claims
Methotrexate
Methotrexate Sodium
322
Prednisone
291
Hydroxychloroquine Sulfate
236
Allopurinol
206
Duloxetine Hcl
180
Leflunomide
141
Pantoprazole Sodium
78
Alendronate Sodium
53
Folic Acid
51
Meloxicam
43

* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.

Rheumatology Physician Overview

How Carla Gamarra-Hilburn, M.D fits within the Rheumatology Physician landscape nationally.

6,181
Rheumatology Physician Providers in US
52
States with Rheumatology Physician
2,054
Avg Claims per Provider

Carla Gamarra-Hilburn, M.D's 2,037 claims are below the specialty average of 2,054.

Nearby Rheumatology Physician Providers in Indiana

Other clinicians with the same primary specialty enrolled in Indiana, drawn from the same CMS NPPES roster as Gamarra-Hilburn.

Compare Rheumatology 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 Indiana medical board, federal registration is not a license check. Credential verification guide
  • Weigh a second option: compare this provider with a nearby Rheumatology 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.

Frequently Asked Questions

What is Carla Gamarra-Hilburn, M.D's specialty?
Carla Gamarra-Hilburn, M.D specializes in Rheumatology Physician and practices in New Albany, Indiana. Credentials: M.D.
How much does Carla Gamarra-Hilburn, M.D prescribe under Medicare Part D?
In 2023, Carla Gamarra-Hilburn, M.D wrote 2,037 Medicare Part D claims totaling $736K in drug costs for 243 beneficiaries.
What is Carla Gamarra-Hilburn, M.D's Medicare quality score?
Carla Gamarra-Hilburn, M.D has a CMS MIPS Final Score of 97.5/100 (Quality: 95). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Carla Gamarra-Hilburn, M.D located?
Carla Gamarra-Hilburn, M.D is located at 1919 STATE ST STE 462, New Albany, IN, 47150. Phone: (812) 725-0200.
What is Carla Gamarra-Hilburn, M.D's NPI number?
Carla Gamarra-Hilburn, M.D's National Provider Identifier (NPI) is 1679861702, issued on 07/11/2011.
Does Carla Gamarra-Hilburn, M.D prescribe more brand-name or generic drugs?
Carla Gamarra-Hilburn, M.D's prescribing is 9% brand-name and 90% generic drugs by claim count, with $693K in brand drug costs.
How many Rheumatology Physician providers are there in the US?
There are 6,181 Rheumatology Physician providers across 52 states in the US. The average Rheumatology Physician provider writes 2,054 Medicare Part D claims per year.
What drugs does Carla Gamarra-Hilburn, M.D prescribe most often?
Based on 2023 Medicare Part D data, Carla Gamarra-Hilburn, M.D's most frequently prescribed drugs include Methotrexate, Prednisone, Hydroxychloroquine Sulfate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Carla Gamarra-Hilburn, M.D accept Medicare?
Carla Gamarra-Hilburn, M.D appears in CMS Medicare data with 2,037 Part D claims and 243 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Carla Gamarra-Hilburn, M.D's credentials?
Carla Gamarra-Hilburn, M.D's NPI is 1679861702 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

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.
Quality Performance
CMS Merit-based Incentive Payment System (MIPS) - 2023 performance year.
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.