NPI registry status
Active
2026 NPPES data Infectious Disease Physician NPI 1063578516 MD
Verify on CMS → Sonali Hemachandra, MD
Infectious Disease Physician in Wheat Ridge, Colorado.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 8,314 in Infectious Disease 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
163
Medicare Part D claims · 35 beneficiaries · Infectious Disease Physician avg: 816
Generic prescribing
64%
generic claims · 36% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
94.5/100
▲ 11 pts above national avg 83.5 · Exceptional
Source: CMS Medicare Part D Prescriber Public Use File, 2023
What the federal data shows
Sonali Hemachandra, MD reported a CMS MIPS final score of 94.5/100 - above the 83.5 national average - and filed 163 Medicare Part D claims in 2023.
- 94.5/100
- MIPS score · +11 vs avg
- 163
- Part D claims, 2023
- 64%
- 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.
Sonali Hemachandra, MD's MIPS score vs every measured U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure. Clinicians whose score CMS assigned without scoring any category are excluded.
95 ≥ 73rd percentile 73% of 454,083 measured providers are in lower value bands
Each bar is a band; taller bars hold more measured 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.
The percentile is a conservative whole-score-point band: it counts only measured clinicians in lower score bands. A CMS MIPS metric is not a recommendation or a clinical-quality rating by PlainDoctor. See methodology § corpus placement.
Source CMS Merit-based Incentive Payment System (MIPS) · 2023
Where Sonali Hemachandra, MD sits
This provider among infectious disease physician peers
Across the 2,130 infectious disease physician providers who report both Medicare Part D prescribing and a MIPS quality score, Sonali Hemachandra, MD writes more Part D claims than 28% of them and scores higher on MIPS quality than 74% - placing this provider in the lower-volume, high-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Each dot is one infectious disease physician peer from a representative sample of 60; the gold marker is Sonali Hemachandra, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Sonali Hemachandra, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting - 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 Sonali Hemachandra, MD?
High performer (top quartile)Primary specialty
Infectious Disease Physician
Medicare Part D claims
163 80% vs specialty avg
MIPS final score
94.5/100 11 pts vs avg
Specialty distribution in Colorado
How Infectious Disease Physician compares to other specialties among Colorado providers
Medicare quality performance, MIPS
Sonali Hemachandra, MD's 2023 MIPS final score plotted against the Infectious Disease Physician national average
- MIPS Final Score
- 94.5/100
- vs 83.5 national avg · 2023 performance year
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).
Sonali Hemachandra, MD appears in the CMS NPPES registry as an Infectious Disease Physician provider holding MD credentials at 3885 UPHAM ST, Wheat Ridge, CO, 80033, with a listed phone of (303) 425-9245. NPI 1063578516 was issued on 12/29/2006.
Medicare Part D records for calendar year 2023 show 163 prescription claims written by this provider, covering 35 Medicare beneficiaries and totaling roughly $316K in drug spend, split 36% brand-name and 64% generic by claim count. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 94.5/100 for the 2023 performance year (Quality 97.3, Cost 55), compared with the 83.5 average among clinicians with a measured score.
Infectious Disease Physician is a mid-sized specialty nationwide, with 8,314 enrolled providers across 54 states and an average of 816 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
Provider Details
| NPI | 1063578516 |
|---|---|
| Specialty | Infectious Disease Physician |
| Credentials | MD |
| Gender | Female |
| NPI Issued | 12/29/2006 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
94.5292
Final Score
Measured-score avg: 83.5
97.3006
Quality
54.99
Cost
Reporting: Group practice
Brand vs generic prescribing mix · Above average
Sonali Hemachandra, MD - brand share 36.0%
Infectious Disease Physician average
36% brand-name claims vs 64% generic, on 163 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.
163
Total Claims
$316K
Total Drug Cost
35
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 283
- Total Day Supply
- 8,329
- Brand vs Generic
- 36% brand / 64% generic
- Brand Drug Cost
- $309K
- Generic Drug Cost
- $7K
- Antibiotic Claims
- 86
Patient Demographics
- Average Patient Age
- 71.5 years
- Avg HCC Risk Score
- 2.25
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Sonali Hemachandra, MD prescribes most
Top Medicare Part D drugs by claim count, 2023
- Cephalexin
Cephalexin
27 claims
- Doxycycline Hyclate
Doxycycline Hyclate
24 claims
- Rukobia
Rukobia
13 claims
- Tivicay
Tivicay
13 claims
- Odefsey
Odefsey
12 claims
| Drug | Claims |
|---|---|
| Cephalexin | 27 |
| Doxycycline Hyclate | 24 |
| Rukobia Fostemsavir Tromethamine | 13 |
| Tivicay Dolutegravir Sodium | 13 |
| Odefsey Emtricitab/Rilpiviri/Tenof Ala | 12 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Infectious Disease Physician Overview
How Sonali Hemachandra, MD fits within the Infectious Disease Physician landscape nationally.
8,314
Infectious Disease Physician Providers in US
54
States with Infectious Disease Physician
816
Avg Claims per Provider
Sonali Hemachandra, MD's 163 claims are below the specialty average of 816.
Nationwide Infectious Disease Physician peers with similar MIPS or enrollment year
Two federal-record peer sets for Hemachandra, both outside Colorado so the neighborhoods are not geographic containment.
Similar MIPS final score
Nearest same-specialty clinicians by CMS MIPS final score (94.5 here).
Same NPPES enumeration year (2006)
Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.
Nearby Infectious Disease Physician Providers in Colorado
Other clinicians with the same primary specialty enrolled in Colorado, drawn from the same CMS NPPES roster as Hemachandra.
One of 149 Infectious Disease Physician providers enrolled in Colorado, 5 are shown here.
Dr. Samer Alyaseen
MD
Aurora, CO
Dr. Andrew Ambler
D.O.
Denver, CO
Dr. Wendy Armstrong
MD
Aurora, CO
Dr. Sandhya Ayyar
M.D.
Aurora, CO
Dr. Wendy Bamberg
MD
Colorado Springs, CO
Compare Infectious Disease 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 Colorado medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Infectious Disease 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.
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Frequently Asked Questions
What is Sonali Hemachandra, MD's specialty? ▼
Sonali Hemachandra, MD specializes in Infectious Disease Physician and practices in Wheat Ridge, Colorado. Credentials: MD.
How much does Sonali Hemachandra, MD prescribe under Medicare Part D? ▼
In 2023, Sonali Hemachandra, MD wrote 163 Medicare Part D claims totaling $316K in drug costs for 35 beneficiaries.
What is Sonali Hemachandra, MD's Medicare quality score? ▼
Sonali Hemachandra, MD has a CMS MIPS Final Score of 94.5/100 (Quality: 97.3, Cost: 55). The average MIPS Final Score across the 454,083 clinicians with at least one published category score is 83.5; clinicians whose score CMS assigned without scoring any category are excluded from that average. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Sonali Hemachandra, MD located? ▼
Sonali Hemachandra, MD is located at 3885 UPHAM ST, Wheat Ridge, CO, 80033. Phone: (303) 425-9245.
What is Sonali Hemachandra, MD's NPI number? ▼
Sonali Hemachandra, MD's National Provider Identifier (NPI) is 1063578516, issued on 12/29/2006.
Does Sonali Hemachandra, MD prescribe more brand-name or generic drugs? ▼
Sonali Hemachandra, MD's prescribing is 36% brand-name and 64% generic drugs by claim count, with $309K in brand drug costs.
How many Infectious Disease Physician providers are there in the US? ▼
There are 8,314 Infectious Disease Physician providers across 54 states in the US. The average Infectious Disease Physician provider writes 816 Medicare Part D claims per year.
What drugs does Sonali Hemachandra, MD prescribe most often? ▼
Based on 2023 Medicare Part D data, Sonali Hemachandra, MD's most frequently prescribed drugs include Cephalexin, Doxycycline Hyclate, Rukobia. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Sonali Hemachandra, MD accept Medicare? ▼
Sonali Hemachandra, MD appears in CMS Medicare data with 163 Part D claims and 35 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Sonali Hemachandra, MD's credentials? ▼
Sonali Hemachandra, MD's NPI is 1063578516 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
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 (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
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 May 2026.