Physician

Shailesh Gandhi, MD

According to 2025 Medicare claims, Shailesh Gandhi, MD (NPI: 1992758783) practices pain management in the Racine-Mount Pleasant, WI market, with the plurality of this provider's patient population coming from Racine, WI. This provider's primary affiliated billing organization is ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. (NPI: 1295769321; TIN: 200217581) and primary practice location at 53177-1604. Gandhi is affiliated with the ProHealth Solutions, LLC (ACO ID: A4979) and Ascension Care Management Health Partners Wisconsin, LLC (ACO ID: A5329), participating under the MSSP model.

Gandhi's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 247 traditional Medicare patients, billed 946 HCPCS/CPT codes, and received $85,128 in Medicare payments. The top billing code was 99204 (New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more). Part D data shows 502 prescription claims across 176 beneficiaries totaling $15,727 in drug costs, led by Hydrocodone-Acetaminophen (Hydrocodone/Acetaminophen). Open Payments data shows 51 records totaling $1,627. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has changed little. Concurrently, Part D prescription costs have moved up and down with repeated peaks and valleys, starting at $47,563 and ending at $15,727. For DME billing, this provider has fewer than 5 years of reported data, so a reliable trend cannot be assigned.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	299	1,368	$91,121
2016	178	1,301	$79,170
2017	163	1,341	$85,426
2018	181	1,234	$74,121
2019	264	1,172	$74,804
2020	250	973	$74,931
2021	263	1,510	$104,669
2022	239	1,058	$90,663
2023	299	1,195	$99,453
2024	247	946	$85,128

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	115	693	$47,563
2016	150	625	$43,544
2017	174	842	$85,175
2018	162	651	$56,659
2019	597	1,420	$129,411
2020	423	825	$40,307
2021	492	1,045	$59,934
2022	553	1,146	$64,938
2023	285	569	$15,031
2024	176	502	$15,727

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

No connected DME records

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
99204	New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	101	101	$116
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	111	176	$86
64483	Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level	61	67	$85
62323	Injection of substance into lower spine canal using imaging guidance	65	71	$67
64484	Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level	59	65	$39

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Hydrocodone-Acetaminophen	Hydrocodone/Acetaminophen	136	3,242	$2,383
Lidocaine	Lidocaine	13	465	$1,035
Oxycodone-Acetaminophen	Oxycodone Hcl/Acetaminophen	46	1,223	$904
Gabapentin	Gabapentin	68	2,589	$881
Pregabalin	Pregabalin	35	1,350	$483

Top 5 DME services in 2024

No connected or detailed DME service-level records for 2024.

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	51	$1,627	SPR Therapeutics, Inc
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

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FAQ

What Medicare data is available for Shailesh Gandhi, MD?

Tedicare shows public-source Medicare data for Shailesh Gandhi, MD (NPI 1992758783), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Shailesh Gandhi, MD have ACO affiliation data?

Shailesh Gandhi, MD is shown with ACO affiliation data for ProHealth Solutions, LLC (MSSP, ACO ID A4979) and Ascension Care Management Health Partners Wisconsin, LLC (MSSP, ACO ID A5329).

What billing organization is linked to Shailesh Gandhi, MD?

Shailesh Gandhi, MD is linked to ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. (billing NPI 1295769321) in the available physician profile data.

Does Shailesh Gandhi, MD have Open Payments data?

Shailesh Gandhi, MD has 51 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.