2026 NPPES data Gastroenterology Physician NPI 1164494811 M.D.
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Kalman Edelman, M.D.

Gastroenterology Physician in Pasadena, California. This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 16,567 in Gastroenterology 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
574
Medicare Part D claims · 174 beneficiaries · Gastroenterology Physician avg: 833
Generic prescribing
85%
generic claims · 15% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
84/100
▲ 1 pts above national avg 83.1 · Above neutral
Industry payments
$1.2K
57 payments · CMS Open Payments (Sunshine Act)
Compiled from official public sources by the PlainDoctor editorial team.

What the federal data shows

Kalman Edelman, M.D. reported a CMS MIPS final score of 84/100 - above the 83.1 national average - and filed 574 Medicare Part D claims in 2023.

84/100
MIPS score · +1 vs avg
574
Part D claims, 2023
85%
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.

Kalman Edelman, 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

84 42nd percentile higher than 42% 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%). This entry sits in this band. 90+: 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

Where Kalman Edelman, M.D. sits

This provider among gastroenterology physician peers

Across the 5,957 gastroenterology physician providers who report both Medicare Part D prescribing and a MIPS quality score, Kalman Edelman, M.D. writes more Part D claims than 37% of them and scores higher on MIPS quality than 49% - placing this provider in the lower-volume, lower-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 quality02550751000255075100Part D claim volume, percentile in specialtyMIPS quality, percentilePart D claim volume, percentile in specialty: 67 · MIPS quality, percentile: 83Part D claim volume, percentile in specialty: 52 · MIPS quality, percentile: 70Part D claim volume, percentile in specialty: 57 · MIPS quality, percentile: 8Part D claim volume, percentile in specialty: 73 · MIPS quality, percentile: 87Part D claim volume, percentile in specialty: 5 · MIPS quality, percentile: 38Part D claim volume, percentile in specialty: 60 · MIPS quality, percentile: 77Part D claim volume, percentile in specialty: 65 · MIPS quality, percentile: 30Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 45Part D claim volume, percentile in specialty: 45 · MIPS quality, percentile: 7Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 47Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 58Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 3Part D claim volume, percentile in specialty: 80 · MIPS quality, percentile: 20Part D claim volume, percentile in specialty: 38 · MIPS quality, percentile: 10Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 97Part D claim volume, percentile in specialty: 43 · MIPS quality, percentile: 27Part D claim volume, percentile in specialty: 90 · MIPS quality, percentile: 57Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 15Part D claim volume, percentile in specialty: 92 · MIPS quality, percentile: 97Part D claim volume, percentile in specialty: 13 · MIPS quality, percentile: 48Part D claim volume, percentile in specialty: 22 · MIPS quality, percentile: 78Part D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 80Part D claim volume, percentile in specialty: 7 · MIPS quality, percentile: 22Part D claim volume, percentile in specialty: 23 · MIPS quality, percentile: 23Part D claim volume, percentile in specialty: 8 · MIPS quality, percentile: 43Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 67Part D claim volume, percentile in specialty: 15 · MIPS quality, percentile: 42Part D claim volume, percentile in specialty: 72 · MIPS quality, percentile: 25Part D claim volume, percentile in specialty: 68 · MIPS quality, percentile: 82Part D claim volume, percentile in specialty: 3 · MIPS quality, percentile: 50Part D claim volume, percentile in specialty: 77 · MIPS quality, percentile: 30Part D claim volume, percentile in specialty: 28 · MIPS quality, percentile: 92Part D claim volume, percentile in specialty: 87 · MIPS quality, percentile: 62Part D claim volume, percentile in specialty: 50 · MIPS quality, percentile: 13Part D claim volume, percentile in specialty: 63 · MIPS quality, percentile: 10Part D claim volume, percentile in specialty: 82 · MIPS quality, percentile: 63Part D claim volume, percentile in specialty: 33 · MIPS quality, percentile: 52Part D claim volume, percentile in specialty: 78 · MIPS quality, percentile: 28Part D claim volume, percentile in specialty: 12 · MIPS quality, percentile: 85Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 40Part D claim volume, percentile in specialty: 0 · MIPS quality, percentile: 37Part D claim volume, percentile in specialty: 48 · MIPS quality, percentile: 3Part D claim volume, percentile in specialty: 100 · MIPS quality, percentile: 17Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 68Part D claim volume, percentile in specialty: 93 · MIPS quality, percentile: 92Part D claim volume, percentile in specialty: 75 · MIPS quality, percentile: 30Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 75Part D claim volume, percentile in specialty: 25 · MIPS quality, percentile: 2Part D claim volume, percentile in specialty: 55 · MIPS quality, percentile: 18Part D claim volume, percentile in specialty: 70 · MIPS quality, percentile: 88Part D claim volume, percentile in specialty: 83 · MIPS quality, percentile: 97Part D claim volume, percentile in specialty: 40 · MIPS quality, percentile: 70Part D claim volume, percentile in specialty: 10 · MIPS quality, percentile: 65Part D claim volume, percentile in specialty: 88 · MIPS quality, percentile: 88Part D claim volume, percentile in specialty: 58 · MIPS quality, percentile: 30Part D claim volume, percentile in specialty: 85 · MIPS quality, percentile: 52Part D claim volume, percentile in specialty: 98 · MIPS quality, percentile: 95Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 70Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 52Part D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 0Kalman Edelman, M.D.-Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 49
Part D claim volume vs MIPS quality, by specialty percentile

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

Board certification likely (heuristic, not verified)

Kalman Edelman, 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 Kalman Edelman, M.D.?

Near national average

NPI registry status

Active

Issued 02/06/2006

NPI 1164494811

Primary specialty

Gastroenterology Physician

Mid-sized

16,567 US NPIs in this specialty

Medicare Part D claims

574 31% vs specialty avg

2023 prescription claims

Specialty avg: 833

MIPS final score

84/100 0.9 pts vs avg

Above neutral band

vs 83.1 national avg

Specialty distribution in California

How Gastroenterology Physician compares to other specialties among California providers

California providers

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

Behavior Technician - 17.3%Behavior Technician17.3%Marriage & Family Therapist - 5.5%Marriage & Family Therapist5.5%Student in an Organized Health Care Education/Training Program - 5%Student in an Organized Health Care Education/Training Program5%Mental Health Counselor - 3.9%Mental Health Counselor3.9%Pharmacist - 3.5%Pharmacist3.5%Clinical Social Worker - 3.1%Clinical Social Worker3.1%Gastroenterology Physician - 0.2%Gastroenterology Physician0.2%
Largest specialties in California (% of in-state providers)

Medicare quality performance, MIPS

Kalman Edelman, M.D.'s 2023 MIPS final score plotted against the Gastroenterology Physician national average

Near national average
MIPS Final Score
84/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Gastroenterology Physician) - 84/100 vs national avg 83.1

0%100%National avg83%84%
MIPS final score (Gastroenterology Physician) - 84/100 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).

Kalman Edelman, M.D. appears in the CMS NPPES registry as a Gastroenterology Physician provider holding M.D. credentials at 50 ALESSANDRO PL, Pasadena, CA, 91105, with a listed phone of (626) 793-7114. NPI 1164494811 was issued on 02/06/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what Edelman 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 574 prescription claims written by this provider, covering 174 Medicare beneficiaries and totaling roughly $498K in drug spend, split 15% brand-name and 85% 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 84/100 for the 2023 performance year (Quality 79.4), compared with the national average of 83.1.

Gastroenterology Physician is a mid-sized specialty nationwide, with 16,567 enrolled providers across 54 states and an average of 833 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

50 ALESSANDRO PL
Pasadena, CA 91105

Provider Details

NPI 1164494811
Specialty Gastroenterology Physician
Credentials M.D.
Gender Male
NPI Issued 02/06/2006

CMS Quality Score (MIPS)

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

83.9994
Final Score
Avg: 83.1
79.4078
Quality

Reporting: Group practice

Hospital and facility affiliations

Facilities where Kalman Edelman, 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.

Genesis Healthcare Partners PC
Pasadena, CA

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 Kalman Edelman, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$1.2K

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 - California MBC 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 ~150K California medical licensees in 2023 - they are NOT specific to Kalman Edelman, M.D.. To verify Kalman Edelman, M.D.'s current license status, search the MBC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

576
Total board actions, California 2023
Across 556 cases
3.84
Actions per 1,000 licensees
California statewide rate
probation
Most common action type
186 cases

MBC 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 California disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Typical

Kalman Edelman, M.D. - brand share 15.0%
Gastroenterology Physician average

15% brand-name claims vs 85% generic, on 574 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.

574
Total Claims
$498K
Total Drug Cost
174
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
1,025
Total Day Supply
29,801
Brand vs Generic
15% brand / 85% generic
Brand Drug Cost
$459K
Generic Drug Cost
$39K
Antibiotic Claims
20

Patient Demographics

Average Patient Age
74.6 years
Avg HCC Risk Score
1.65
Gender Split
60% female / 40% male
Age Distribution
<65: 11, 65-74: 81, 75-84: 64, 85+: 18

Top Prescribed Drugs (Medicare Part D)

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

What Kalman Edelman, 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
Omeprazole
174
Famotidine
50
Pantoprazole Sodium
48
Linzess
Linaclotide
37
Diphenoxylate-Atropine
Diphenoxylate Hcl/Atropine
27
Mesalamine
24
Sucralfate
23
Dicyclomine Hcl
20
Esomeprazole Magnesium
15
Stelara
Ustekinumab
11

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

Gastroenterology Physician Overview

How Kalman Edelman, M.D. fits within the Gastroenterology Physician landscape nationally.

16,567
Gastroenterology Physician Providers in US
54
States with Gastroenterology Physician
833
Avg Claims per Provider

Kalman Edelman, M.D.'s 574 claims are below the specialty average of 833.

Nearby Gastroenterology Physician Providers in California

Other clinicians with the same primary specialty enrolled in California, drawn from the same CMS NPPES roster as Edelman.

Compare Gastroenterology 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 California medical board, federal registration is not a license check. Credential verification guide
  • Weigh a second option: compare this provider with a nearby Gastroenterology 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 Kalman Edelman, M.D.'s specialty?
Kalman Edelman, M.D. specializes in Gastroenterology Physician and practices in Pasadena, California. Credentials: M.D..
How much does Kalman Edelman, M.D. prescribe under Medicare Part D?
In 2023, Kalman Edelman, M.D. wrote 574 Medicare Part D claims totaling $498K in drug costs for 174 beneficiaries.
What is Kalman Edelman, M.D.'s Medicare quality score?
Kalman Edelman, M.D. has a CMS MIPS Final Score of 84/100 (Quality: 79.4). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Kalman Edelman, M.D. located?
Kalman Edelman, M.D. is located at 50 ALESSANDRO PL, Pasadena, CA, 91105. Phone: (626) 793-7114.
What is Kalman Edelman, M.D.'s NPI number?
Kalman Edelman, M.D.'s National Provider Identifier (NPI) is 1164494811, issued on 02/06/2006.
Does Kalman Edelman, M.D. prescribe more brand-name or generic drugs?
Kalman Edelman, M.D.'s prescribing is 15% brand-name and 85% generic drugs by claim count, with $459K in brand drug costs.
How many Gastroenterology Physician providers are there in the US?
There are 16,567 Gastroenterology Physician providers across 54 states in the US. The average Gastroenterology Physician provider writes 833 Medicare Part D claims per year.
What drugs does Kalman Edelman, M.D. prescribe most often?
Based on 2023 Medicare Part D data, Kalman Edelman, M.D.'s most frequently prescribed drugs include Omeprazole, Famotidine, Pantoprazole Sodium. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Kalman Edelman, M.D. accept Medicare?
Kalman Edelman, M.D. appears in CMS Medicare data with 574 Part D claims and 174 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Kalman Edelman, M.D.'s credentials?
Kalman Edelman, M.D.'s NPI is 1164494811 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.