NPI registry status
Active
2026 NPPES data Rheumatology Physician NPI 1417141763 M.D.
Verify on CMS → Carlos Gadea, M.D.
Rheumatology Physician in Montgomery, Alabama.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 6,377 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
4K
Medicare Part D claims · 452 beneficiaries · Rheumatology Physician avg: 2K
Generic prescribing
86%
generic claims · 14% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
80.9/100
▼ 3 pts below national avg 83.5 · Above neutral
Industry payments
$63.56
3 payments · CMS Open Payments (Sunshine Act)
Source: CMS Medicare Part D Prescriber Public Use File, 2024
What the federal data shows
Carlos Gadea, M.D. reported a CMS MIPS final score of 80.9/100 - below the 83.5 national average - and filed 4,172 Medicare Part D claims in 2024.
- 80.9/100
- MIPS score · -3 vs avg
- 4K
- Part D claims, 2024
- 86%
- 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.
Federal trust snapshot
What official records show about Carlos Gadea, M.D.
Federal records show an active NPI with both Medicare prescribing volume and a measured CMS quality score — objective registry data, not patient reviews.
- Verified
NPI registry status
Active listing in the CMS National Provider Identifier Registry (NPI 1417141763), first enumerated 08/29/2007.
Source: CMS NPPES
- Reported
Medicare Part D participation
Filed 4,172 Medicare Part D prescription claims in the 2023 CMS public use file — indicates active Medicare prescribing participation.
Source: CMS Part D Prescriber PUF
- Reported
CMS quality reporting (MIPS)
Reported a CMS MIPS final score of 80.9/100 in the Quality Payment Program — a federal quality measure, not a patient review.
Source: CMS Quality Payment Program
- Reported
Board certification signal
Heuristic suggests board-certified status based on ABMS-eligible specialty taxonomy plus active CMS participation signals — not a direct ABMS verification.
- Reported
Hospital affiliations
1 CMS Care Compare hospital affiliation on record — practice footprint from the Doctors and Clinicians file.
Source: CMS Care Compare
- Reported
Industry payment transparency
$63.56 in reported industry payments (3 transfers) in 2024 under the federal Sunshine Act — disclosed transfers of value, not a quality rating.
Source: CMS Open Payments
- Not in federal data
Individual sanction lookup
PlainDoctor does not publish per-provider disciplinary determinations. Confirm current license and any individual actions through the state medical board or FSMB verification service.
Source: State medical board / FSMB
This trust snapshot summarizes only what appears in federal CMS/NPPES public records. It is not a composite score, star rating, patient review, or clinical recommendation. PlainDoctor never fabricates reviews or AggregateRating schema.
CMS NPPES provider registry desk
NPI 1417141763 · Rheumatology Physician
NPI-10 · ENUM-MID · TAX-MID · MIPS-INLINE · RX-MID · BOOK-THIN · PHOTO-FINISH
- NPI-10 1417141763
- ENUM-MID 2007
- TAX-MID 6K Rheumatology Physician
- MIPS-INLINE 80.9/100
- RX-MID 4,172
- BOOK-THIN 87 in Alabama
- PHOTO-FINISH Inocencio Cuesta · ±0.1
MIPS final-score neighbourhood
Same-specialty nationwide peers by CMS final score, not geographic proximity
- Melissa Reily · …
Melissa Reily
80.8 MIPS pts
- Nisha Manek · near
Nisha Manek
80.8 MIPS pts
- Lauren Johnson ·…
Lauren Johnson
80.8 MIPS pts
- Gadea · this pro…
Gadea · this provider
80.9 MIPS pts
- Inocencio Cuesta…
Inocencio Cuesta
81 MIPS pts
What this shows Nearest measured MIPS peers for this NUCC specialty (2023 performance year).
Carlos Gadea, M.D.'s MIPS score vs every measured U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure. Clinicians whose score CMS assigned without scoring any category are excluded.
81 ≥ 30th percentile 30% of 454,083 measured providers are in lower value bands
Each bar is a band; taller bars hold more measured 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.
The percentile is a conservative whole-score-point band: it counts only measured clinicians in lower score bands. A CMS MIPS metric is not a recommendation or a clinical-quality rating by PlainDoctor. See methodology § corpus placement.
Source CMS Merit-based Incentive Payment System (MIPS) · 2023
Where Carlos Gadea, M.D. sits
This provider among rheumatology physician peers
Across the 1,970 rheumatology physician providers who report both Medicare Part D prescribing and a MIPS quality score, Carlos Gadea, M.D. writes more Part D claims than 86% of them and scores higher on MIPS quality than 32% - placing this provider in the high-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Each dot is one rheumatology physician peer from a representative sample of 60; the gold marker is Carlos Gadea, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Carlos Gadea, 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 Carlos Gadea, M.D.?
Near national averagePrimary specialty
Rheumatology Physician
Medicare Part D claims
4,172 103% vs specialty avg
MIPS final score
80.9/100 2.6 pts vs avg
Specialty distribution in Alabama
How Rheumatology Physician compares to other specialties among Alabama providers
Medicare quality performance, MIPS
Carlos Gadea, M.D.'s 2023 MIPS final score plotted against the Rheumatology Physician national average
- MIPS Final Score
- 80.9/100
- vs 83.5 national avg · 2023 performance year
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).
Practice Address
Provider Details
| NPI | 1417141763 |
|---|---|
| Specialty | Rheumatology Physician |
| Credentials | M.D. |
| Gender | Male |
| NPI Issued | 08/29/2007 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
80.8774
Final Score
Measured-score avg: 83.5
76.7063
Quality
59.5518
Cost
100
Promoting Interoperability
Reporting: Group practice
Hospital and facility affiliations
Facilities where Carlos Gadea, 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.
Health Care Authority For Baptist Health, AN Affiliate OF Uabhs
Montgomery, AL
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 Carlos Gadea, M.D.. Source: openpaymentsdata.cms.gov.
Total received
$64
Largest payer
GlaxoSmithKline, LLC.
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 · Typical
Carlos Gadea, M.D. - brand share 14.0%
Rheumatology Physician average
14% brand-name claims vs 86% generic, on 4,172 2024 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 2024.
4,172
Total Claims
$3.8M
Total Drug Cost
452
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 6,157.167
- Total Day Supply
- 179,079
- Brand vs Generic
- 14% brand / 86% generic
- Brand Drug Cost
- $3.6M
- Generic Drug Cost
- $138K
- Opioid Claims
- 193 (4.6% rate)
- Antibiotic Claims
- 28
Patient Demographics
- Average Patient Age
- 67.2 years
- Avg HCC Risk Score
- 1.51
- Gender Split
- 77% female / 23% male
- Age Distribution
- <65: 144, 65-74: 180, 75-84: 108, 85+: 20
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2024. Based on Medicare Part D data only.
What Carlos Gadea, M.D. prescribes most
Top Medicare Part D drugs by claim count, 2024
- Hydroxychloroquine…
Hydroxychloroquine Sulfate
807 claims
- Methotrexate
Methotrexate
606 claims
- Prednisone
Prednisone
397 claims
- Tramadol Hcl 169
Tramadol Hcl
169 claims
- Leflunomide 167
Leflunomide
167 claims
- Duloxetine Hcl 166
Duloxetine Hcl
166 claims
- Allopurinol 139
Allopurinol
139 claims
- Enbrel Sureclick 138
Enbrel Sureclick
138 claims
| Drug | Claims |
|---|---|
| Hydroxychloroquine Sulfate | 807 |
| Methotrexate Methotrexate Sodium | 606 |
| Prednisone | 397 |
| Tramadol Hcl | 169 |
| Leflunomide | 167 |
| Duloxetine Hcl | 166 |
| Allopurinol | 139 |
| Enbrel Sureclick Etanercept | 138 |
| Gabapentin | 128 |
| Humira(Cf) Pen Adalimumab | 110 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Rheumatology Physician Overview
How Carlos Gadea, M.D. fits within the Rheumatology Physician landscape nationally.
6,377
Rheumatology Physician Providers in US
52
States with Rheumatology Physician
2,058
Avg Claims per Provider
Carlos Gadea, M.D.'s 4,172 claims are above the specialty average of 2,058.
Nationwide Rheumatology Physician peers with similar MIPS or enrollment year
Two federal-record peer sets for Gadea, both outside Alabama so the neighborhoods are not geographic containment.
Similar MIPS final score
Nearest same-specialty clinicians by CMS MIPS final score (80.9 here).
Same NPPES enumeration year (2007)
Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.
Nearby Rheumatology Physician Providers in Alabama
Other clinicians with the same primary specialty enrolled in Alabama, drawn from the same CMS NPPES roster as Gadea.
One of 87 Rheumatology Physician providers enrolled in Alabama, 5 are shown here.
Dr. Joel Abbott
MD
Mountain Brk, AL
Dr. Hamdy Ahmed
MD
Mobile, AL
Dr. Graciela Alarcon
MD
Birmingham, AL
Amanda Alexander
Birmingham, AL
Dr. Zarmeena Ali
MD
Opelika, AL
Compare Rheumatology Physician nationally: see state-by-state distribution →
Frequently Asked Questions
What is Carlos Gadea, M.D.'s specialty? ▼
Carlos Gadea, M.D. specializes in Rheumatology Physician and practices in Montgomery, Alabama. Credentials: M.D..
How much does Carlos Gadea, M.D. prescribe under Medicare Part D? ▼
In 2024, Carlos Gadea, M.D. wrote 4,172 Medicare Part D claims totaling $3.8M in drug costs for 452 beneficiaries.
What is Carlos Gadea, M.D.'s Medicare quality score? ▼
Carlos Gadea, M.D. has a CMS MIPS Final Score of 80.9/100 (Quality: 76.7, Cost: 59.6). The average MIPS Final Score across the 454,083 clinicians with at least one published category score is 83.5; clinicians whose score CMS assigned without scoring any category are excluded from that average. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Carlos Gadea, M.D. located? ▼
Carlos Gadea, M.D. is located at 2119 E SOUTH BLVD, Montgomery, AL, 36116. Phone: (334) 613-7070.
What is Carlos Gadea, M.D.'s NPI number? ▼
Carlos Gadea, M.D.'s National Provider Identifier (NPI) is 1417141763, issued on 08/29/2007.
Does Carlos Gadea, M.D. prescribe more brand-name or generic drugs? ▼
Carlos Gadea, M.D.'s prescribing is 14% brand-name and 86% generic drugs by claim count, with $3.6M in brand drug costs.
Does Carlos Gadea, M.D. prescribe opioids? ▼
Yes, Carlos Gadea, M.D. had 193 opioid claims in 2024 with an opioid prescribing rate of 4.6%.
How many Rheumatology Physician providers are there in the US? ▼
There are 6,377 Rheumatology Physician providers across 52 states in the US. The average Rheumatology Physician provider writes 2,058 Medicare Part D claims per year.
What drugs does Carlos Gadea, M.D. prescribe most often? ▼
Based on 2024 Medicare Part D data, Carlos Gadea, M.D.'s most frequently prescribed drugs include Hydroxychloroquine Sulfate, Methotrexate, Prednisone. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Carlos Gadea, M.D. accept Medicare? ▼
Carlos Gadea, M.D. appears in CMS Medicare data with 4,172 Part D claims and 452 Medicare beneficiaries in 2024. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Carlos Gadea, M.D.'s credentials? ▼
Carlos Gadea, M.D.'s NPI is 1417141763 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 (2024). 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 August 2026 (NPPES) / 2024 (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
Every figure on PlainDoctor is rendered directly from the federal CMS NPPES registry, Medicare Part D, MIPS, and Open Payments records, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of August 2026.