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    OpenPayerNPI Medicare & MedicaidShanta Gautham
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    Shanta Gautham — Billing Profile & Reimbursement Data

    NPI 1851562375 · Grand Forks, ND · Internal Medicine Physician

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    Shanta Gautham is a internal medicine physician provider located in Grand Forks, North Dakota. This profile covers 9 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationShanta Gautham
    Address725 Hamline St - Altru Family Medicine Residency
    CityGrand Forks
    StateND
    ZIP58203
    TaxonomyInternal Medicine Physician
    NPI EnumeratedMarch 13, 2008

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$130.6K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    9 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99215The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…580$90$53.1K
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…480$70$32.7K
    G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit240$130$30.7K
    99496The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires high–level medical decision making, contact…30$150$4.5K
    99204The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…30$90$2.8K
    G0438Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit20$160$2.5K
    99203The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…40$60$2.3K
    G0402Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment10$130$1.7K
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…10$50$560

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    9 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    99214961,47090$60$10.4K
    G0439927050$100$6.9K
    99215348040$100$6.9K
    992131,4621,49080$50$5.8K
    9920425057030$100$4.4K
    G0438428020$130$2.6K
    9920316049030$60$2.5K
    G0402102010$130$2K
    9949634020$110$1.9K

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Shanta Gautham, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Altru Health SystemNDClinic/Center$0$29.7M
    Altru Health SystemNDGeneral Acute Care Hospital$0$18.7M
    Max JohnsonNDRetina Specialist (Ophthalmology) Physician$2.8M$0
    Altru Health SystemNDRural Health Clinic/Center$0$1.5M
    Dwight FitchFLRadiation Oncology Physician$1.5M$0
    Altru Health SystemNDAmbulance$527.6K$490.7K
    P R Health CorporationNDRural Health Clinic/Center$0$1M
    Darrin JohnsonMNDiagnostic Radiology Physician$908.4K$0
    Shree SubediWADiagnostic Radiology Physician$774.2K$0
    Altru Specialty Services, IncNDDurable Medical Equipment & Medical Supplies$0$766.7K

    Nearby Providers

    Other providers in the same ZIP code as Shanta Gautham, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Grand Forks Growth And Support CenterNDCommunity/Behavioral Health Agency$0$7.4M
    Sharehouse Grand ForksNDSubstance Use Disorder Rehabilitation Clinic/Center$0$4.1M
    All Embracing Home Care, LLCNDHome Health Agency$0$456.1K
    Prairie Harvest Mental HealthNDCommunity/Behavioral Health Agency$0$243.1K
    Guardian Flight LLCNDAir Ambulance$188.9K$0
    Sara NausheenNDInfectious Disease Physician$110.3K$0
    Diane BaumbachNDClinical Social Worker$0$106.6K
    Bruce PehlNDFamily Medicine Physician$99.5K$0
    A NielsenNDFamily Medicine Physician$57.8K$0
    Paragon Chiropractic And Wellness CenterNDChiropractor$0$55.7K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. North Dakota Distribution
    Shanta Gautham — 2 of 9 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — North Dakota