2026 NPPES data Pulmonary Disease Physician NPI 1538123542 M.D.
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GAURANG PATEL, M.D.

Pulmonary Disease Physician in DENVILLE, New Jersey. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.

Federal data — no proprietary rating. PlainDoctor publishes the actual CMS NPPES and Medicare records — NPI registration, specialty, practice location, and prescribing data — without a composite score or editorial opinion on top. Every field traces to a federal source.
Prescribing volume
2K
Medicare Part D claims · 276 beneficiaries · Pulmonary Disease Physician avg: 1K
Generic prescribing
41%
generic claims · 59% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
75/100
▼ 8 pts below national avg 83.1 · [object Object]
Industry payments
$62.55
3 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

GAURANG PATEL, M.D. reported a CMS MIPS final score of 75/100 — below the 83.1 national average — and filed 1,586 Medicare Part D claims in 2023.

75/100
MIPS score · -8 vs avg
2K
Part D claims, 2023
41%
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.

GAURANG PATEL, 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

75 15th percentile higher than 15% 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%). This entry sits in this band. 80–90: 129,887 scored providers (27%). Above this entry. 90–100: 189,403 scored providers (40%). Above this entry. 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

Board certification likely (heuristic — not verified)

GAURANG PATEL, 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 GAURANG PATEL, M.D.?

Below national average

NPI registry status

Active

Issued 04/14/2006

NPI 1538123542

Primary specialty

Pulmonary Disease Physician

Mid-sized

9,271 US NPIs in this specialty

Medicare Part D claims

1,586 9% vs specialty avg

2023 prescription claims

Specialty avg: 1,457

MIPS final score

75/100 8.099999999999994% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in New Jersey

How Pulmonary Disease Physician compares to other specialties among New Jersey providers

New Jersey providers

Pulmonary Disease Physician share within New Jersey

1. Pulmonary Disease Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Pulmonary Disease Physician share within New Jersey

Medicare quality performance — MIPS

GAURANG PATEL, M.D.'s 2023 MIPS final score plotted against the Pulmonary Disease Physician national average

Below national average
MIPS Final Score
75/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Pulmonary Disease Physician) — 75/100 vs national avg 83.1

0%100%National avg83%75%
MIPS final score (Pulmonary Disease Physician) — 75/100 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).

GAURANG PATEL, M.D. appears in the CMS NPPES registry as a Pulmonary Disease Physician provider holding M.D. credentials at 16 POCONO RD 217, DENVILLE, NJ, 07834, with a listed phone of (800) 750-8616. NPI 1538123542 was issued on 04/14/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what PATEL 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 1,586 prescription claims written by this provider, covering 276 Medicare beneficiaries and totaling roughly $799K in drug spend, split 59% brand-name and 41% 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 75/100 for the 2023 performance year, compared with the national average of 83.1.

Pulmonary Disease Physician is a mid-sized specialty nationwide, with 9,271 enrolled providers across 53 states and an average of 1,457 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

16 POCONO RD 217
DENVILLE, NJ 07834

Provider Details

NPI 1538123542
Specialty Pulmonary Disease Physician
Credentials M.D.
Gender Male
NPI Issued 04/14/2006

CMS Quality Score (MIPS)

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

75
Final Score
Avg: 83.1

Reporting: Group practice

Hospital and facility affiliations

Facilities where GAURANG PATEL, 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.

TRUDOC LLC
DENVILLE, NJ

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 GAURANG PATEL, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$63

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 · Brand-heavy

GAURANG PATEL, M.D. — brand share 59.0%
Specialty average (est.)

59% brand-name claims vs 41% generic, on 1,586 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.

1,586
Total Claims
$799K
Total Drug Cost
276
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
2,860
Total Day Supply
84,231
Brand vs Generic
59% brand / 41% generic
Brand Drug Cost
$749K

Patient Demographics

Average Patient Age
77.2 years
Avg HCC Risk Score
1.79
Gender Split
54% female / 46% male

Top Prescribed Drugs (Medicare Part D)

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

What GAURANG PATEL, 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
Trelegy Ellipta
Fluticasone/Umeclidin/Vilanter
201
Albuterol Sulfate Hfa
Albuterol Sulfate
173
Breo Ellipta
Fluticasone/Vilanterol
171
Montelukast Sodium
87
Prednisone
62
Anoro Ellipta
Umeclidinium Brm/Vilanterol Tr
60
Stiolto Respimat
Tiotropium Br/Olodaterol Hcl
56
Fluticasone-Salmeterol
Fluticasone Propion/Salmeterol
52
Spiriva Handihaler
Tiotropium Bromide
49
Symbicort
Budesonide/Formoterol Fumarate
44

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

Pulmonary Disease Physician Overview

How GAURANG PATEL, M.D. fits within the Pulmonary Disease Physician landscape nationally.

9,271
Pulmonary Disease Physician Providers in US
53
States with Pulmonary Disease Physician
1,457
Avg Claims per Provider

GAURANG PATEL, M.D.'s 1,586 claims are above the specialty average of 1,457.

Nearby Pulmonary Disease Physician Providers in New Jersey

Other clinicians with the same primary specialty enrolled in New Jersey, drawn from the same CMS NPPES roster as PATEL.

Compare Pulmonary Disease Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is GAURANG PATEL, M.D.'s specialty?
GAURANG PATEL, M.D. specializes in Pulmonary Disease Physician and practices in DENVILLE, New Jersey. Credentials: M.D..
How much does GAURANG PATEL, M.D. prescribe under Medicare Part D?
In 2023, GAURANG PATEL, M.D. wrote 1,586 Medicare Part D claims totaling $799K in drug costs for 276 beneficiaries.
What is GAURANG PATEL, M.D.'s Medicare quality score?
GAURANG PATEL, M.D. has a CMS MIPS Final Score of 75/100. The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is GAURANG PATEL, M.D. located?
GAURANG PATEL, M.D. is located at 16 POCONO RD 217, DENVILLE, NJ, 07834. Phone: (800) 750-8616.
What is GAURANG PATEL, M.D.'s NPI number?
GAURANG PATEL, M.D.'s National Provider Identifier (NPI) is 1538123542, issued on 04/14/2006.
Does GAURANG PATEL, M.D. prescribe more brand-name or generic drugs?
GAURANG PATEL, M.D.'s prescribing is 59% brand-name and 41% generic drugs by claim count, with $749K in brand drug costs.
How many Pulmonary Disease Physician providers are there in the US?
There are 9,271 Pulmonary Disease Physician providers across 53 states in the US. The average Pulmonary Disease Physician provider writes 1,457 Medicare Part D claims per year.
What drugs does GAURANG PATEL, M.D. prescribe most often?
Based on 2023 Medicare Part D data, GAURANG PATEL, M.D.'s most frequently prescribed drugs include Trelegy Ellipta, Albuterol Sulfate Hfa, Breo Ellipta. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does GAURANG PATEL, M.D. accept Medicare?
GAURANG PATEL, M.D. appears in CMS Medicare data with 1,586 Part D claims and 276 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify GAURANG PATEL, M.D.'s credentials?
GAURANG PATEL, M.D.'s NPI is 1538123542 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