2026 NPPES data Rheumatology Physician NPI 1295029338 M.D.
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SUZANNE GILMAN, M.D.

Rheumatology Physician in WORCESTER, Massachusetts. 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
2K
Medicare Part D claims · 343 beneficiaries · Rheumatology Physician avg: 2K
What the federal data reveals: SUZANNE GILMAN, M.D. is a Rheumatology Physician ([object Object]) practicing in WORCESTER, Massachusetts with a Medicare Part D prescribing footprint of 2K claims across 343 beneficiaries .

What stands out: SUZANNE GILMAN, M.D. filed 1,827 Medicare Part D claims in 2023 across WORCESTER, Massachusetts. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board certification likely (heuristic — not verified)

SUZANNE GILMAN, 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).

SUZANNE GILMAN, M.D. at a glance

Quality data not reported

NPI registry status

Active

Issued 06/07/2011

NPI 1295029338

Primary specialty

Rheumatology Physician

Mid-sized

6,181 US NPIs in this specialty

Medicare Part D claims

1,827 11% vs specialty avg

2023 prescription claims

Specialty avg: 2,054

Specialty distribution in Massachusetts

How Rheumatology Physician compares to other specialties among Massachusetts providers

Massachusetts providers

Rheumatology Physician share within Massachusetts

1. Rheumatology Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Rheumatology Physician share within Massachusetts

Specialty board-certification context

Estimated specialty board-certified rate — Rheumatology Physician (ABMS / AOA reference)

Quality data not reported
Est. board-certified rate
78%
Rheumatology Physician ABMS/AOA estimate

Est. board-certified rate (Rheumatology Physician) — ABMS / AOA estimate

0%100%78%
Est. board-certified rate (Rheumatology 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).

SUZANNE GILMAN, M.D. is a Rheumatology Physician provider practicing in WORCESTER, Massachusetts, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1295029338. 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.

SUZANNE GILMAN, M.D. appears in the CMS NPPES registry as a Rheumatology Physician provider holding M.D. credentials at 5 NEPONSET ST, WORCESTER, MA, 01606, with a listed phone of (508) 595-2855. NPI 1295029338 was issued on 06/07/2011. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what GILMAN 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 1,827 prescription claims written by this provider, covering 343 Medicare beneficiaries and totaling roughly $2.9 million in drug spend, with an opioid prescribing rate of 0.9%. 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.

Rheumatology Physician is a mid-sized specialty nationwide, with 6,181 enrolled providers across 52 states and an average of 2,054 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

5 NEPONSET ST
WORCESTER, MA 01606

Provider Details

NPI 1295029338
Specialty Rheumatology Physician
Credentials M.D.
Gender Female
NPI Issued 06/07/2011

Hospital and facility affiliations

Facilities where SUZANNE GILMAN, 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.

RELIANT MEDICAL GROUP INC
WORCESTEER, MA

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 — Massachusetts BORIM 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 ~38K Massachusetts medical licensees in 2023 — they are NOT specific to SUZANNE GILMAN, M.D.. To verify SUZANNE GILMAN, M.D.'s current license status, search the BORIM public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

80
Total board actions, Massachusetts 2023
Across 78 cases
2.11
Actions per 1,000 licensees
Massachusetts statewide rate
probation
Most common action type
29 cases

BORIM 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 Massachusetts 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 2023.

1,827
Total Claims
$2.9M
Total Drug Cost
343
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
3,405
Total Day Supply
100,312
Generic Drug Cost
$69K
Opioid Claims
17 (0.9% rate)

Patient Demographics

Average Patient Age
71.9 years
Avg HCC Risk Score
1.95
Gender Split
71% female / 29% male
Age Distribution
<65: 58, 65-74: 143, 75-84: 109, 85+: 33

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Hydroxychloroquine Sulfate
296
Methotrexate
Methotrexate Sodium
294
Prednisone
163
Alendronate Sodium
134
Allopurinol
116
Humira(Cf) Pen
Adalimumab
111
Leflunomide
88
Enbrel Sureclick
Etanercept
56
Meloxicam
42
Folic Acid
39

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

Rheumatology Physician Overview

How SUZANNE GILMAN, M.D. fits within the Rheumatology Physician landscape nationally.

6,181
Rheumatology Physician Providers in US
52
States with Rheumatology Physician
2,054
Avg Claims per Provider

SUZANNE GILMAN, M.D.'s 1,827 claims are below the specialty average of 2,054.

Nearby Rheumatology Physician Providers in Massachusetts

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

Compare Rheumatology Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is SUZANNE GILMAN, M.D.'s specialty?
SUZANNE GILMAN, M.D. specializes in Rheumatology Physician and practices in WORCESTER, Massachusetts. Credentials: M.D..
How much does SUZANNE GILMAN, M.D. prescribe under Medicare Part D?
In 2023, SUZANNE GILMAN, M.D. wrote 1,827 Medicare Part D claims totaling $2.9M in drug costs for 343 beneficiaries.
Where is SUZANNE GILMAN, M.D. located?
SUZANNE GILMAN, M.D. is located at 5 NEPONSET ST, WORCESTER, MA, 01606. Phone: (508) 595-2855.
What is SUZANNE GILMAN, M.D.'s NPI number?
SUZANNE GILMAN, M.D.'s National Provider Identifier (NPI) is 1295029338, issued on 06/07/2011.
Does SUZANNE GILMAN, M.D. prescribe opioids?
Yes, SUZANNE GILMAN, M.D. had 17 opioid claims in 2023 with an opioid prescribing rate of 0.9%.
How many Rheumatology Physician providers are there in the US?
There are 6,181 Rheumatology Physician providers across 52 states in the US. The average Rheumatology Physician provider writes 2,054 Medicare Part D claims per year.
What drugs does SUZANNE GILMAN, M.D. prescribe most often?
Based on 2023 Medicare Part D data, SUZANNE GILMAN, M.D.'s most frequently prescribed drugs include Hydroxychloroquine Sulfate, Methotrexate, Prednisone. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does SUZANNE GILMAN, M.D. accept Medicare?
SUZANNE GILMAN, M.D. appears in CMS Medicare data with 1,827 Part D claims and 343 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify SUZANNE GILMAN, M.D.'s credentials?
SUZANNE GILMAN, M.D.'s NPI is 1295029338 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.
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