Medicare billing address
CMS Medicare provider billing file
500 Plaza Court, Suite APmc Physician Associates Cardiology
East Stroudsburg, PA 18301
CMS public data · NPI 1295729440
Dr. Karthik Sheka: Medicare prescribing and billing data
CMS public files list billing, prescribing, location, and participation fields for this NPI. Current plan networks, appointment availability, clinical outcomes, and patient-specific medical advice require separate verification.
CMS display name
Karthik Sheka, M.D.
Specialty
Credential
M.D.
NPI
1295729440
Primary source state
PA
Data retrieval date
July 26, 2026
What related Medicare data is on this site?
Pennsylvania doctorsState Doctor hubCardiologyState-specialty hubEast Stroudsburg, PAPrimary city link if this route exists
Where these numbers come from, and what they cannot tell you
Public CMS records, 2024 reporting year. These are historical Medicare fields, not proof of current coverage, appointment availability, quality, or what someone will pay.
How should you read this Doctor page?
This page shows Medicare billing and Part D prescribing data for Karthik Sheka, M.D. from CMS public files. It covers 2024 claims data: services billed, the beneficiary panel, and the most-prescribed Part D drugs. It does not show current coverage, appointment availability, or quality ratings.
A licensed agent, not a call center
Do your doctors and prescriptions fit before you enroll?
Peter Abilla, Licensed Medicare Insurance Sales Agent, NPN 22265186. Bring the doctors and prescriptions that matter to you, then check the details before you enroll.
What Medicare source indicators are listed for this NPI?
Medicare participating
Yes
Individual assignment
Yes
Group assignment
Yes
CMS opt-out records
0
Which practice locations appear in CMS files?
When CMS files list more than one address for the same NPI, each address stays tied to the CMS file that reported it.
Pmc Physician Associates Cardiology
East Stroudsburg, PA 18301
LEHIGH VALLEY PHYSICIAN GROUP
CMS Doctors & Clinicians file
100 Community DrSuite 102
Tobyhanna, PA 18466
LEHIGH VALLEY PHYSICIAN GROUP
CMS Doctors & Clinicians file
1210 S Cedar Crest BlvdAllentown, PA 18103
LEHIGH VALLEY PHYSICIAN GROUP
CMS Doctors & Clinicians file
200 E Brown StLvpg Family Medicine Esu
East Stroudsburg, PA 18301
What does the Medicare billing file show?
In the 2024 CMS provider billing file, this NPI had 2,047 Medicare beneficiaries and 3,819 total services. The average beneficiary age was 74, and the average HCC risk score was 1.6.
Total Medicare allowed amount
$196,161.32
Total Medicare payment amount
$143,140.59
Medicare beneficiaries
2,047
Total services
3,819
Which patient-panel condition fields does CMS report?
These percentages describe the Medicare beneficiary panel in the CMS utilization file. They are not a diagnosis for any individual patient and are not a quality score.
Hyperlipidemia
75%
CMS beneficiary-panel share
Hypertension
75%
CMS beneficiary-panel share
Ischemic heart disease
44%
CMS beneficiary-panel share
Diabetes
39%
CMS beneficiary-panel share
Chronic kidney disease
36%
CMS beneficiary-panel share
COPD
30%
CMS beneficiary-panel share
Where these service numbers come from, and what they cannot tell you
Amounts shown are average Medicare-approved amounts per billed unit in CMS records. What a person pays depends on current coverage and cannot be read from this table alone.
Which Medicare services appear most often?
| CMS service description | Services | Avg allowed |
|---|---|---|
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 1,330 | $7.52 |
| Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 489 | $117.87 |
| Ultrasound of heart with color-depicted blood flow, rate, direction and valve function | 481 | $63.38 |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 263 | $13.36 |
| Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician | 176 | $12.93 |
| Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician | 147 | $19.57 |
| New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | 132 | $154.28 |
| Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 132 | $123.37 |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 106 | $74.29 |
| Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's | 103 | $15.44 |
Where these Part D numbers come from, and what they cannot tell you
CMS data reports historical prescription drug events attributed to NPI 1295729440. Formularies, copays, prior authorization, and step therapy rules vary by current coverage.
Which drugs did Karthik Sheka, M.D. prescribe most often under Medicare Part D?
| Rank | Drug | Generic name | Total claims | 30-day fills | Total drug cost |
|---|---|---|---|---|---|
| 1 | Metoprolol Succinate | Metoprolol Succinate | 400 | 1,150.5 | $6,793.94 |
| 2 | Atorvastatin Calcium | Atorvastatin Calcium | 386 | 1,117.7 | $3,805.59 |
| 3 | Eliquis | Apixaban | 271 | 668.5 | $375,485.44 |
| 4 | Rosuvastatin Calcium | Rosuvastatin Calcium | 243 | 692 | $4,092.79 |
| 5 | Lisinopril | Lisinopril | 238 | 703.9 | $1,632.81 |
| 6 | Metoprolol Tartrate | Metoprolol Tartrate | 188 | 528.5 | $1,823.90 |
| 7 | Amlodipine Besylate | Amlodipine Besylate | 171 | 506.3 | $1,206.48 |
| 8 | Clopidogrel | Clopidogrel Bisulfate | 141 | 406 | $2,099.59 |
| 9 | Losartan Potassium | Losartan Potassium | 131 | 385.7 | $1,663.48 |
| 10 | Furosemide | Furosemide | 108 | 305 | $714.07 |
CMS Part D records are historical aggregate claims data. They do not include current formulary status, pharmacy price, prior-authorization rules, network-directory status, or clinical-outcome data.
What background fields does CMS report?
Graduation year
1997
Group/practice field
Lehigh Valley Physician Group
Telehealth reported
Yes
What can this data not tell us?
- Billing data and prescribing data come from different CMS files. Neither one measures clinical outcomes, and neither one tells you whether this doctor is in a specific plan's network.
- Part D records do not report current medication use, plan coverage, price, pharmacy availability, or plan-directory status.
- Where CMS withholds a count for privacy, we show that note instead of a number. A withheld count is not zero.
- CMS billing data does not list Medicare Advantage plan-directory status for this doctor.
- CMS service and prescribing records are historical public-use aggregates; they do not report current appointment availability, clinical outcomes, or patient-specific medical advice.
- Part D provider-and-drug records do not include current formulary status, copay amount, pharmacy price, prior-authorization rules, or step-therapy rules.
What should you verify separately?
Verify plan-directory status, drug formulary rules, pharmacy pricing, appointment availability, and clinical questions against current plan documents and the relevant provider or care team.
Which CMS sources support this page?
The numbers above come from CMS public-use files for this NPI. Each link identifies the CMS release used and the retrieval date.
- Medicare Physician & Other Practitioners - by Provider · 1 records for this NPI · retrieved July 26, 2026
- Medicare Physician & Other Practitioners - by Provider and Service · 22 records for this NPI · retrieved July 26, 2026
- Doctors and Clinicians National Downloadable File · 9 records for this NPI · retrieved July 26, 2026
- Opt-Out Affidavits · 0 records for this NPI · retrieved July 26, 2026
- Medicare Part D Prescribers - by Provider and Drug · 36 records for this NPI · retrieved July 26, 2026
What caveats apply to this page?
- CMS billing and utilization files do not list Medicare Advantage plan networks, appointment availability, or clinical outcomes.
- Part D provider-and-drug files are historical aggregate claims data; they do not report current medication lists, plan coverage, pharmacy price, or prior-authorization rules.
- Where CMS withholds a count for privacy, we show that note instead of a number. A withheld count is not zero.