2026 NPPES data Pulmonary Disease Physician NPI 1285615245 M.D.
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HESHAM EL GAMAL, M.D.

Pulmonary Disease Physician in BOWLING GREEN, Ohio. 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
426
Medicare Part D claims · 92 beneficiaries · Pulmonary Disease Physician avg: 1K
MIPS score
34.217/100
▼ 49 pts below national avg 83.1 · [object Object]
Industry payments
$396.34
11 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

HESHAM EL GAMAL, M.D. reported a CMS MIPS final score of 34.217/100 — below the 83.1 national average — and filed 426 Medicare Part D claims in 2023.

34.217/100
MIPS score · -49 vs avg
426
Part D claims, 2023
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.

HESHAM EL GAMAL, 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

34 3rd percentile higher than 3% 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%). This entry sits in this band. 40–50: 2,928 scored providers (1%). Above this entry. 50–60: 5,882 scored providers (1%). Above this entry. 60–70: 13,906 scored providers (3%). Above this entry. 70–80: 118,074 scored providers (25%). Above this entry. 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)

HESHAM EL GAMAL, 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 HESHAM EL GAMAL, M.D.?

Below national average

NPI registry status

Active

Issued 11/08/2005

NPI 1285615245

Primary specialty

Pulmonary Disease Physician

Mid-sized

9,271 US NPIs in this specialty

Medicare Part D claims

426 71% vs specialty avg

2023 prescription claims

Specialty avg: 1,457

MIPS final score

34.217/100 48.882999999999996% pts

Below average band

vs 83.1 national avg

Specialty distribution in Ohio

How Pulmonary Disease Physician compares to other specialties among Ohio providers

Ohio providers

Pulmonary Disease Physician share within Ohio

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

Medicare quality performance — MIPS

HESHAM EL GAMAL, M.D.'s 2023 MIPS final score plotted against the Pulmonary Disease Physician national average

Below national average
MIPS Final Score
34.217/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Pulmonary Disease Physician) — 34.217/100 vs national avg 83.1

0%100%National avg83%34.2%
MIPS final score (Pulmonary Disease Physician) — 34.217/100 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).

HESHAM EL GAMAL, M.D. appears in the CMS NPPES registry as a Pulmonary Disease Physician provider holding M.D. credentials at 960 W WOOSTER ST, BOWLING GREEN, OH, 43402, with a listed phone of (419) 373-7692. NPI 1285615245 was issued on 11/08/2005. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what EL GAMAL 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 426 prescription claims written by this provider, covering 92 Medicare beneficiaries and totaling roughly $91K in drug spend, with an opioid prescribing rate of 3.3%. 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 34.217/100 for the 2023 performance year (Quality 41.2067, Cost 35.0927), 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

960 W WOOSTER ST
BOWLING GREEN, OH 43402

Provider Details

NPI 1285615245
Specialty Pulmonary Disease Physician
Credentials M.D.
Gender Male
NPI Issued 11/08/2005

CMS Quality Score (MIPS)

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

34.217
Final Score
Avg: 83.1
41.2067
Quality
35.0927
Cost

Reporting: Individual

Hospital and facility affiliations

Facilities where HESHAM EL GAMAL, 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.

SPECIALTY PHYSICIANS OF BLANCHARD VALLEY LLC
FINDLAY, OH

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 HESHAM EL GAMAL, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$396

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.

License & disciplinary context — Ohio OMB 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 ~48K Ohio medical licensees in 2023 — they are NOT specific to HESHAM EL GAMAL, M.D.. To verify HESHAM EL GAMAL, M.D.'s current license status, search the OMB public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

158
Total board actions, Ohio 2023
Across 154 cases
3.29
Actions per 1,000 licensees
Ohio statewide rate
probation
Most common action type
56 cases

OMB 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 Ohio disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

426
Total Claims
$91K
Total Drug Cost
92
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
507
Total Day Supply
11,685
Generic Drug Cost
$11K
Opioid Claims
14 (3.3% rate)
Antibiotic Claims
30

Patient Demographics

Average Patient Age
73.8 years
Avg HCC Risk Score
2.43
Gender Split
53% female / 47% male
Age Distribution
<65: 18, 65-74: 23, 75-84: 34, 85+: 17

Top Prescribed Drugs (Medicare Part D)

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

What HESHAM EL GAMAL, 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
Albuterol Sulfate Hfa
Albuterol Sulfate
96
Prednisone
44
Spiriva Handihaler
Tiotropium Bromide
37
Combivent Respimat
Ipratropium/Albuterol Sulfate
28
Symbicort
Budesonide/Formoterol Fumarate
25
Budesonide
17
Fluticasone-Salmeterol
Fluticasone Propion/Salmeterol
13
Atorvastatin Calcium
12
Azithromycin
12
Cefuroxime
Cefuroxime Axetil
12

* 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 HESHAM EL GAMAL, 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

HESHAM EL GAMAL, M.D.'s 426 claims are below the specialty average of 1,457.

Nearby Pulmonary Disease Physician Providers in Ohio

Other clinicians with the same primary specialty enrolled in Ohio, drawn from the same CMS NPPES roster as EL GAMAL.

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

Frequently Asked Questions

What is HESHAM EL GAMAL, M.D.'s specialty?
HESHAM EL GAMAL, M.D. specializes in Pulmonary Disease Physician and practices in BOWLING GREEN, Ohio. Credentials: M.D..
How much does HESHAM EL GAMAL, M.D. prescribe under Medicare Part D?
In 2023, HESHAM EL GAMAL, M.D. wrote 426 Medicare Part D claims totaling $91K in drug costs for 92 beneficiaries.
What is HESHAM EL GAMAL, M.D.'s Medicare quality score?
HESHAM EL GAMAL, M.D. has a CMS MIPS Final Score of 34.217/100 (Quality: 41.2067, Cost: 35.0927). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is HESHAM EL GAMAL, M.D. located?
HESHAM EL GAMAL, M.D. is located at 960 W WOOSTER ST, BOWLING GREEN, OH, 43402. Phone: (419) 373-7692.
What is HESHAM EL GAMAL, M.D.'s NPI number?
HESHAM EL GAMAL, M.D.'s National Provider Identifier (NPI) is 1285615245, issued on 11/08/2005.
Does HESHAM EL GAMAL, M.D. prescribe opioids?
Yes, HESHAM EL GAMAL, M.D. had 14 opioid claims in 2023 with an opioid prescribing rate of 3.3%.
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 HESHAM EL GAMAL, M.D. prescribe most often?
Based on 2023 Medicare Part D data, HESHAM EL GAMAL, M.D.'s most frequently prescribed drugs include Albuterol Sulfate Hfa, Prednisone, Spiriva Handihaler. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does HESHAM EL GAMAL, M.D. accept Medicare?
HESHAM EL GAMAL, M.D. appears in CMS Medicare data with 426 Part D claims and 92 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify HESHAM EL GAMAL, M.D.'s credentials?
HESHAM EL GAMAL, M.D.'s NPI is 1285615245 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