2026 NPPES data Internal Medicine Physician NPI 1851562375 MD
Verify on CMS →

SHANTA GAUTHAM, MD

Internal Medicine Physician in GRAND FORKS, North Dakota. 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
8K
Medicare Part D claims · 502 beneficiaries · Internal Medicine Physician avg: 3K
Generic prescribing
89%
generic claims · 11% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
97.5814/100
▲ 14 pts above national avg 83.1 · [object Object]
Industry payments
$103.79
2 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: SHANTA GAUTHAM, MD is a Internal Medicine Physician ([object Object]) practicing in GRAND FORKS, North Dakota with a Medicare Part D prescribing footprint of 8K claims across 502 beneficiaries — 11% brand-name prescribing . Their CMS MIPS Final Score of 97.5814/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $103.79 across 2 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: SHANTA GAUTHAM, MD reported a CMS MIPS final score of 97.5814 out of 100, above the 83.1 national average, and filed 7,663 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board certification likely (heuristic — not verified)

SHANTA GAUTHAM, MD 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).

SHANTA GAUTHAM, MD at a glance

High performer (top quartile)

NPI registry status

Active

Issued 03/13/2008

NPI 1851562375

Primary specialty

Internal Medicine Physician

High-volume

172,858 US NPIs in this specialty

Medicare Part D claims

7,663 182% vs specialty avg

2023 prescription claims

Specialty avg: 2,716

MIPS final score

97.5814/100 14.481400000000008% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in North Dakota

How Internal Medicine Physician compares to other specialties among North Dakota providers

North Dakota providers

Internal Medicine Physician share within North Dakota

1. Internal Medicine Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Internal Medicine Physician share within North Dakota

Medicare quality performance — MIPS

SHANTA GAUTHAM, MD's 2023 MIPS final score plotted against the Internal Medicine Physician national average

High performer (top quartile)
MIPS Final Score
97.5814/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Internal Medicine Physician) — 97.5814/100 vs national avg 83.1

0%100%National avg83%97.6%
MIPS final score (Internal Medicine Physician) — 97.5814/100 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).

SHANTA GAUTHAM, MD is a Internal Medicine Physician provider practicing in GRAND FORKS, North Dakota, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD. NPI: 1851562375. 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.

SHANTA GAUTHAM, MD appears in the CMS NPPES registry as a Internal Medicine Physician provider holding MD credentials at 725 HAMLINE ST - ALTRU FAMILY MEDICINE RESIDENCY, GRAND FORKS, ND, 58203, with a listed phone of (701) 780-6800. NPI 1851562375 was issued on 03/13/2008. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what GAUTHAM 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 7,663 prescription claims written by this provider, covering 502 Medicare beneficiaries and totaling roughly $776K in drug spend, split 11% brand-name and 89% generic by claim count, with an opioid prescribing rate of 0.5%. 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 97.5814/100 for the 2023 performance year (Quality 86.5348), compared with the national average of 83.1.

Internal Medicine Physician is a high-volume specialty nationwide, with 172,858 enrolled providers across 56 states and an average of 2,716 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

725 HAMLINE ST - ALTRU FAMILY MEDICINE RESIDENCY
GRAND FORKS, ND 58203

Provider Details

NPI 1851562375
Specialty Internal Medicine Physician
Credentials MD
Gender Female
NPI Issued 03/13/2008

CMS Quality Score (MIPS)

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

97.5814
Final Score
Avg: 83.1
86.5348
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

Hospital and facility affiliations

Facilities where SHANTA GAUTHAM, MD 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.

ALTRU HEALTH SYSTEM
GRAND FORKS, ND

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 SHANTA GAUTHAM, MD. Source: openpaymentsdata.cms.gov.

Total received

$104

Largest payer

Phathom Pharmaceuticals, 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.

Brand vs generic prescribing mix · Typical

SHANTA GAUTHAM, MD — brand share 11.0%
Specialty average (est.)

11% brand-name claims vs 89% generic, on 7,663 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.

7,663
Total Claims
$776K
Total Drug Cost
502
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
16,617
Total Day Supply
486,663
Brand vs Generic
11% brand / 89% generic
Brand Drug Cost
$632K
Generic Drug Cost
$136K
Opioid Claims
42 (0.5% rate)
Antibiotic Claims
133

Patient Demographics

Average Patient Age
74.8 years
Avg HCC Risk Score
1.45
Gender Split
73% female / 27% male
Age Distribution
<65: 49, 65-74: 202, 75-84: 159, 85+: 92

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Simvastatin
380
Atorvastatin Calcium
360
Levothyroxine Sodium
305
Lisinopril
296
Losartan Potassium
266
Hydrochlorothiazide
265
Metoprolol Succinate
265
Rosuvastatin Calcium
246
Omeprazole
225
Amlodipine Besylate
222

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

Internal Medicine Physician Overview

How SHANTA GAUTHAM, MD fits within the Internal Medicine Physician landscape nationally.

172,858
Internal Medicine Physician Providers in US
56
States with Internal Medicine Physician
2,716
Avg Claims per Provider

SHANTA GAUTHAM, MD's 7,663 claims are above the specialty average of 2,716.

Nearby Internal Medicine Physician Providers in North Dakota

Other clinicians with the same primary specialty enrolled in North Dakota, drawn from the same CMS NPPES roster as GAUTHAM.

Compare Internal Medicine Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is SHANTA GAUTHAM, MD's specialty?
SHANTA GAUTHAM, MD specializes in Internal Medicine Physician and practices in GRAND FORKS, North Dakota. Credentials: MD.
How much does SHANTA GAUTHAM, MD prescribe under Medicare Part D?
In 2023, SHANTA GAUTHAM, MD wrote 7,663 Medicare Part D claims totaling $776K in drug costs for 502 beneficiaries.
What is SHANTA GAUTHAM, MD's Medicare quality score?
SHANTA GAUTHAM, MD has a CMS MIPS Final Score of 97.5814/100 (Quality: 86.5348). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is SHANTA GAUTHAM, MD located?
SHANTA GAUTHAM, MD is located at 725 HAMLINE ST - ALTRU FAMILY MEDICINE RESIDENCY, GRAND FORKS, ND, 58203. Phone: (701) 780-6800.
What is SHANTA GAUTHAM, MD's NPI number?
SHANTA GAUTHAM, MD's National Provider Identifier (NPI) is 1851562375, issued on 03/13/2008.
Does SHANTA GAUTHAM, MD prescribe more brand-name or generic drugs?
SHANTA GAUTHAM, MD's prescribing is 11% brand-name and 89% generic drugs by claim count, with $632K in brand drug costs.
Does SHANTA GAUTHAM, MD prescribe opioids?
Yes, SHANTA GAUTHAM, MD had 42 opioid claims in 2023 with an opioid prescribing rate of 0.5%.
How many Internal Medicine Physician providers are there in the US?
There are 172,858 Internal Medicine Physician providers across 56 states in the US. The average Internal Medicine Physician provider writes 2,716 Medicare Part D claims per year.
What drugs does SHANTA GAUTHAM, MD prescribe most often?
Based on 2023 Medicare Part D data, SHANTA GAUTHAM, MD's most frequently prescribed drugs include Simvastatin, Atorvastatin Calcium, Levothyroxine Sodium. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does SHANTA GAUTHAM, MD accept Medicare?
SHANTA GAUTHAM, MD appears in CMS Medicare data with 7,663 Part D claims and 502 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify SHANTA GAUTHAM, MD's credentials?
SHANTA GAUTHAM, MD's NPI is 1851562375 with credentials MD. 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