2026 NPPES data Adult Congenital Heart Disease Physician NPI 1043516735 MD, MS
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PRADEEPKUMAR CHARLA, MD, MS

Adult Congenital Heart Disease Physician in ROCHESTER, New York. 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
264
Medicare Part D claims · 18 beneficiaries · Adult Congenital Heart Disease Physician avg: 2K
Generic prescribing
79%
generic claims · 21% brand-name · higher generic rates reduce patient out-of-pocket costs
What the federal data reveals: PRADEEPKUMAR CHARLA, MD, MS is a Adult Congenital Heart Disease Physician ([object Object]) practicing in ROCHESTER, New York with a Medicare Part D prescribing footprint of 264 claims across 18 beneficiaries — 21% brand-name prescribing .

What stands out: PRADEEPKUMAR CHARLA, MD, MS filed 264 Medicare Part D claims in 2023 across ROCHESTER, New York. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board certification likely (heuristic — not verified)

PRADEEPKUMAR CHARLA, MD, MS 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).

PRADEEPKUMAR CHARLA, MD, MS at a glance

Quality data not reported

NPI registry status

Active

Issued 01/28/2011

NPI 1043516735

Primary specialty

Adult Congenital Heart Disease Physician

Rare

104 US NPIs in this specialty

Medicare Part D claims

264 86% vs specialty avg

2023 prescription claims

Specialty avg: 1,930

Specialty distribution in New York

How Adult Congenital Heart Disease Physician compares to other specialties among New York providers

New York providers

Adult Congenital Heart Disease Physician share within New York

1. Adult Congenital Heart Disease Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Adult Congenital Heart Disease Physician share within New York

Specialty board-certification context

Estimated specialty board-certified rate — Adult Congenital Heart Disease Physician (ABMS / AOA reference)

Quality data not reported
Est. board-certified rate
78%
Adult Congenital Heart Disease Physician ABMS/AOA estimate

Est. board-certified rate (Adult Congenital Heart Disease Physician) — ABMS / AOA estimate

0%100%78%
Est. board-certified rate (Adult Congenital Heart Disease Physician) — ABMS / AOA estimate

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).

PRADEEPKUMAR CHARLA, MD, MS is a Adult Congenital Heart Disease Physician provider practicing in ROCHESTER, New York, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD, MS. NPI: 1043516735. This profile includes practice location, specialty classification, and organizational affiliations from the CMS provider registry. Provider information is self-reported to CMS and updated monthly.

PRADEEPKUMAR CHARLA, MD, MS appears in the CMS NPPES registry as a Adult Congenital Heart Disease Physician provider holding MD, MS credentials at 601 ELMWOOD AVE, ROCHESTER, NY, 14642, with a listed phone of (585) 275-6108. NPI 1043516735 was issued on 01/28/2011. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what CHARLA 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 264 prescription claims written by this provider, covering 18 Medicare beneficiaries and totaling roughly $72K in drug spend, split 21% brand-name and 79% 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.

Adult Congenital Heart Disease Physician is a narrow specialty nationwide, with 104 enrolled providers across 31 states and an average of 1,930 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

601 ELMWOOD AVE
ROCHESTER, NY 14642

Provider Details

NPI 1043516735
Specialty Adult Congenital Heart Disease Physician
Credentials MD, MS
Gender Male
NPI Issued 01/28/2011

Hospital and facility affiliations

Facilities where PRADEEPKUMAR CHARLA, MD, MS 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.

PEDIATRIC CARDIOLOGY
ROCHESTER, NY

Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).

License & disciplinary context — New York NYSBPMC 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 ~100K New York medical licensees in 2023 — they are NOT specific to PRADEEPKUMAR CHARLA, MD, MS. To verify PRADEEPKUMAR CHARLA, MD, MS's current license status, search the NYSBPMC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

312
Total board actions, New York 2023
Across 302 cases
3.12
Actions per 1,000 licensees
New York statewide rate
probation
Most common action type
89 cases

NYSBPMC 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 New York disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Typical

PRADEEPKUMAR CHARLA, MD, MS — brand share 21.0%
Specialty average (est.)

21% brand-name claims vs 79% generic, on 264 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.

264
Total Claims
$72K
Total Drug Cost
18
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
352
Total Day Supply
10,122
Brand vs Generic
21% brand / 79% generic
Brand Drug Cost
$48K
Generic Drug Cost
$24K

Patient Demographics

Average Patient Age
40.7 years
Avg HCC Risk Score
1.75

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Metoprolol Tartrate
34
Jardiance
Empagliflozin
30
Spironolactone
24
Torsemide
22
Metoprolol Succinate
18
Furosemide
14
Eliquis
Apixaban
13
Lisinopril
13
Tadalafil
13
Carvedilol
12

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

Adult Congenital Heart Disease Physician Overview

How PRADEEPKUMAR CHARLA, MD, MS fits within the Adult Congenital Heart Disease Physician landscape nationally.

104
Adult Congenital Heart Disease Physician Providers in US
31
States with Adult Congenital Heart Disease Physician
1,930
Avg Claims per Provider

PRADEEPKUMAR CHARLA, MD, MS's 264 claims are below the specialty average of 1,930.

Nearby Adult Congenital Heart Disease Physician Providers in New York

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

Compare Adult Congenital Heart Disease Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is PRADEEPKUMAR CHARLA, MD, MS's specialty?
PRADEEPKUMAR CHARLA, MD, MS specializes in Adult Congenital Heart Disease Physician and practices in ROCHESTER, New York. Credentials: MD, MS.
How much does PRADEEPKUMAR CHARLA, MD, MS prescribe under Medicare Part D?
In 2023, PRADEEPKUMAR CHARLA, MD, MS wrote 264 Medicare Part D claims totaling $72K in drug costs for 18 beneficiaries.
Where is PRADEEPKUMAR CHARLA, MD, MS located?
PRADEEPKUMAR CHARLA, MD, MS is located at 601 ELMWOOD AVE, ROCHESTER, NY, 14642. Phone: (585) 275-6108.
What is PRADEEPKUMAR CHARLA, MD, MS's NPI number?
PRADEEPKUMAR CHARLA, MD, MS's National Provider Identifier (NPI) is 1043516735, issued on 01/28/2011.
Does PRADEEPKUMAR CHARLA, MD, MS prescribe more brand-name or generic drugs?
PRADEEPKUMAR CHARLA, MD, MS's prescribing is 21% brand-name and 79% generic drugs by claim count, with $48K in brand drug costs.
How many Adult Congenital Heart Disease Physician providers are there in the US?
There are 104 Adult Congenital Heart Disease Physician providers across 31 states in the US. The average Adult Congenital Heart Disease Physician provider writes 1,930 Medicare Part D claims per year.
What drugs does PRADEEPKUMAR CHARLA, MD, MS prescribe most often?
Based on 2023 Medicare Part D data, PRADEEPKUMAR CHARLA, MD, MS's most frequently prescribed drugs include Metoprolol Tartrate, Jardiance, Spironolactone. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does PRADEEPKUMAR CHARLA, MD, MS accept Medicare?
PRADEEPKUMAR CHARLA, MD, MS appears in CMS Medicare data with 264 Part D claims and 18 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify PRADEEPKUMAR CHARLA, MD, MS's credentials?
PRADEEPKUMAR CHARLA, MD, MS's NPI is 1043516735 with credentials MD, MS. 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.
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