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    v1.0.28
    OpenPayerNPI Medicare & MedicaidNilay Gandhi
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    Nilay Gandhi — Billing Profile & Reimbursement Data

    NPI 1861657488 · Woodbridge, VA · Urology Physician

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    Nilay Gandhi is a urology physician provider located in Woodbridge, Virginia. This profile covers 47 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
    OrganizationNilay Gandhi
    Address2296 Opitz Blvd
    CityWoodbridge
    StateVA
    ZIP22191
    TaxonomyUrology Physician
    NPI EnumeratedJuly 23, 2008

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

    Payer SourceTotal Paid
    Medicare$570.1K
    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.

    47 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J1952Leuprolide injectable, camcevi, 1 mg1,090$60$68.8K
    J3145Injection, testosterone undecanoate, 1 mg65,250$1$65.3K
    55874Under imaging guidance, the provider inserts a needle through the perineum, the area between the anus and the scrotum, and injects one or more biodegradable materials, i.e., material that decomposes…50$1,280$57.5K
    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…570$90$52.9K
    J2760Injection, phentolamine mesylate, up to 5 mg130$350$44.9K
    87798The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…830$30$28.3K
    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…350$70$23.2K
    J3490Unclassified drugs30$760$21.4K
    76872The provider inserts an ultrasound probe into the rectum and performs a transrectal ultrasound to assess disorders of the prostate, rectum, and surrounding tissues.210$80$16.3K
    87801The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.190$70$13.2K

    Showing 1–10 of 47

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 47 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    47 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    877981330690$30$159.2K
    J1952210920$70$95.7K
    87481920200$30$59K
    J2760110130$350$44.9K
    J314521012,380$1$36K
    5587452020$800$26.3K
    52356319020$680$21.9K
    992141,59212,890140$80$21K
    J34908711060$280$20.5K
    8764182060$30$16.5K

    Showing 1–10 of 47

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Inova Health Care ServicesVAGeneral Acute Care Hospital$0$176.6M
    Inova Health Care ServicesVAGeneral Acute Care Hospital$0$69M
    Inova Health Care ServicesVAGeneral Acute Care Hospital$0$46.9M
    Inova Health Care ServicesVAGeneral Acute Care Hospital$0$39.3M
    Inova Health Care ServicesVAInternal Medicine Physician$0$38M
    Inova Health Care ServicesVAGeneral Acute Care Hospital$0$33.5M
    Bronson Lakeview HospitalMICritical Access Hospital$0$15.6M
    Inova Health Care ServicesVAClinical Medical Laboratory$5.4M$6.8M
    Fairfax Radiological ConsultantsVASpecialist$0$10.8M
    Inova Health Care ServicesVAPhysical Therapist$0$8.9M

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Potomac Hospital Corporation Of Prince WilliamVAGeneral Acute Care Hospital$0$59.2M
    America's Best Home Healthcare LLC.VAHome Health Agency$0$15.8M
    Blessed Support Professionals, IncVAIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility$0$14.9M
    Whipple Tree Emergency Physicians LLCVAEmergency Medicine Physician$0$13.2M
    Advanced Home Care Connect IncVAHome Health Agency$0$12.4M
    Provident Arc LLCVAIntellectual and/or Developmental Disabilities Residential Treatment Facility$0$11.2M
    Century Pediatrics Inc.VAPediatrics Physician$0$10.9M
    Divine Senior Home Care LLCVAHome Health Agency$0$9M
    Quality Health Services, LLCVAHome Health Agency$0$7.7M
    Abba Home Care LLCVAHome Health Agency$0$7.6M

    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. Virginia Distribution
    Nilay Gandhi — 4 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Virginia