NPI registry status
Active
2026 NPPES data Rheumatology Physician NPI 1053760835 M.D.
Verify on CMS → Jay Ghadiali, M.D.
Rheumatology Physician in Bryn Mawr, Pennsylvania.
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
1K
Medicare Part D claims · 301 beneficiaries · Rheumatology Physician avg: 2K
Industry payments
$2.6K
100 payments · CMS Open Payments (Sunshine Act)
What the federal data shows
Jay Ghadiali, M.D. filed 1,080 Medicare Part D claims in 2024 as a Rheumatology Physician in Bryn Mawr, Pennsylvania.
- 1K
- Part D claims, 2024
- Likely
- board-certified (heuristic)
- ≥75th
- pct by Part D claim volume (lower-bound band)
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 Jay Ghadiali, M.D.
Federal records show an active NPI with Medicare Part D prescribing activity — verifiable registry data, not a proprietary rating.
- Verified
NPI registry status
Active listing in the CMS National Provider Identifier Registry (NPI 1053760835), first enumerated 06/12/2016.
Source: CMS NPPES
- Reported
Medicare Part D participation
Filed 1,080 Medicare Part D prescription claims in the 2023 CMS public use file — indicates active Medicare prescribing participation.
Source: CMS Part D Prescriber PUF
- 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
$2.6K in reported industry payments (100 transfers) in 2024 under the federal Sunshine Act — disclosed transfers of value, not a quality rating.
Source: CMS Open Payments
- State context
State board disciplinary context
Pennsylvania statewide board action statistics are published annually — these figures describe aggregate state activity, not Jay Ghadiali, M.D.'s individual license status. Verify directly with the state medical board.
Source: PA-BOM annual report 2023
- 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 1053760835 · Rheumatology Physician
NPI-10 · ENUM-MID · TAX-MID · RX-MID · BOOK-THIN · PHOTO-ENUM
- NPI-10 1053760835
- ENUM-MID 2016
- TAX-MID 6K Rheumatology Physician
- RX-MID 1,080
- BOOK-THIN 336 in Pennsylvania
- PHOTO-ENUM Ryan Mathew · 2016
Jay Ghadiali, M.D.'s Medicare Part D volume vs every U.S. prescriber
Total Medicare Part D claims, 2024, across all CMS prescribers nationally
1,080 ≥ 75th percentile 75% of 1,416,883 prescribers are in lower value bands
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.
The percentile is a conservative 100-claim band: it counts only prescribers in lower claim-volume bands. Medicare Part D claim volume is activity context, not a quality measure or recommendation. See methodology § corpus placement.
Source CMS Medicare Part D Prescriber Public Use File · 2024
✓
Board certification likely (heuristic, not verified)
Jay Ghadiali, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + 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 Jay Ghadiali, M.D.?
Quality data not reportedPrimary specialty
Rheumatology Physician
Medicare Part D claims
1,080 48% vs specialty avg
Specialty distribution in Pennsylvania
How Rheumatology Physician compares to other specialties among Pennsylvania 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 Rheumatology 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).
Practice Address
Provider Details
| NPI | 1053760835 |
|---|---|
| Specialty | Rheumatology Physician |
| Credentials | M.D. |
| Gender | Male |
| NPI Issued | 06/12/2016 |
Hospital and facility affiliations
Facilities where Jay Ghadiali, 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.
Bryn Mawr Medical Specialists Association
Bryn Mawr, PA
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 Jay Ghadiali, M.D.. Source: openpaymentsdata.cms.gov.
Total received
$2.6K
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 - Pennsylvania PA-BOM 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 ~45K Pennsylvania medical licensees in 2023 - they are NOT specific to Jay Ghadiali, M.D.. To verify Jay Ghadiali, M.D.'s current license status, search the PA-BOM public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.
133
Total board actions, Pennsylvania 2023
Across 129 cases
2.96
Actions per 1,000 licensees
Pennsylvania statewide rate
probation
Most common action type
48 cases
PA-BOM 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 Pennsylvania 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 2024.
1,080
Total Claims
$561K
Total Drug Cost
301
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 2,267.233
- Total Day Supply
- 66,356
- Generic Drug Cost
- $31K
- Opioid Claims
- 46 (4.3% rate)
Patient Demographics
- Average Patient Age
- 73.8 years
- Avg HCC Risk Score
- 1.43
- Gender Split
- 73% female / 27% male
- Age Distribution
- <65: 20, 65-74: 146, 75-84: 103, 85+: 32
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2024. Based on Medicare Part D data only.
What Jay Ghadiali, M.D. prescribes most
Top Medicare Part D drugs by claim count, 2024
- Prednisone
Prednisone
256 claims
- Methotrexate
Methotrexate
138 claims
- Hydroxychloroquine…
Hydroxychloroquine Sulfate
111 claims
- Allopurinol 93
Allopurinol
93 claims
- Alendronate Sodium 69
Alendronate Sodium
69 claims
- Colchicine 36
Colchicine
36 claims
- Leflunomide 28
Leflunomide
28 claims
- Celecoxib 25
Celecoxib
25 claims
| Drug | Claims |
|---|---|
| Prednisone | 256 |
| Methotrexate Methotrexate Sodium | 138 |
| Hydroxychloroquine Sulfate | 111 |
| Allopurinol | 93 |
| Alendronate Sodium | 69 |
| Colchicine | 36 |
| Leflunomide | 28 |
| Celecoxib | 25 |
| Meloxicam | 21 |
| Tramadol Hcl | 21 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Rheumatology Physician Overview
How Jay Ghadiali, 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
Jay Ghadiali, M.D.'s 1,080 claims are below the specialty average of 2,058.
Nationwide Rheumatology Physician peers with similar MIPS or enrollment year
Two federal-record peer sets for Ghadiali, both outside Pennsylvania so the neighborhoods are not geographic containment.
Same NPPES enumeration year (2016)
Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.
Nearby Rheumatology Physician Providers in Pennsylvania
Other clinicians with the same primary specialty enrolled in Pennsylvania, drawn from the same CMS NPPES roster as Ghadiali.
One of 336 Rheumatology Physician providers enrolled in Pennsylvania, 5 are shown here.
Dr. Ravi Acharya
M.D.
Gettysburg, PA
Antonio Achkar
Pittsburgh, PA
Dr. Sandhya Adusumilli
M.D.
Lancaster, PA
Dr. Rohit Aggarwal
M.D.
Pittsburgh, PA
Dr. Shirley Albano
MD
Hershey, PA
Compare Rheumatology Physician nationally: see state-by-state distribution →
Frequently Asked Questions
What is Jay Ghadiali, M.D.'s specialty? ▼
Jay Ghadiali, M.D. specializes in Rheumatology Physician and practices in Bryn Mawr, Pennsylvania. Credentials: M.D..
How much does Jay Ghadiali, M.D. prescribe under Medicare Part D? ▼
In 2024, Jay Ghadiali, M.D. wrote 1,080 Medicare Part D claims totaling $561K in drug costs for 301 beneficiaries.
Where is Jay Ghadiali, M.D. located? ▼
Jay Ghadiali, M.D. is located at 955 E HAVERFORD RD STE 200, Bryn Mawr, PA, 19010. Phone: (610) 525-4463.
What is Jay Ghadiali, M.D.'s NPI number? ▼
Jay Ghadiali, M.D.'s National Provider Identifier (NPI) is 1053760835, issued on 06/12/2016.
Does Jay Ghadiali, M.D. prescribe opioids? ▼
Yes, Jay Ghadiali, M.D. had 46 opioid claims in 2024 with an opioid prescribing rate of 4.3%.
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 Jay Ghadiali, M.D. prescribe most often? ▼
Based on 2024 Medicare Part D data, Jay Ghadiali, M.D.'s most frequently prescribed drugs include Prednisone, Methotrexate, Hydroxychloroquine Sulfate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Jay Ghadiali, M.D. accept Medicare? ▼
Jay Ghadiali, M.D. appears in CMS Medicare data with 1,080 Part D claims and 301 Medicare beneficiaries in 2024. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Jay Ghadiali, M.D.'s credentials? ▼
Jay Ghadiali, M.D.'s NPI is 1053760835 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.
- 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.