Medicare billing address
CMS Medicare provider billing file
1000 Higbee Dr Ste D202Bethel Park, PA 15102
CMS public data · NPI 1013968577
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
Michael P Mcgonigal, M.D.
Specialty
Credential
M.D.
NPI
1013968577
Primary source state
PA
Data retrieval date
July 28, 2026
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.
This page shows Medicare billing and Part D prescribing data for Michael P Mcgonigal, 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
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.
Medicare participating
Yes
Individual assignment
Yes
Group assignment
Yes
CMS opt-out records
0
When CMS files list more than one address for the same NPI, each address stays tied to the CMS file that reported it.
CMS Medicare provider billing file
1000 Higbee Dr Ste D202CMS Doctors & Clinicians file
1000 Higbee DrIn the 2024 CMS provider billing file, this NPI had 608 Medicare beneficiaries and 6,888 total services. The average beneficiary age was 72, and the average HCC risk score was 0.9.
Total Medicare allowed amount
$271,425.49
Total Medicare payment amount
$211,707.18
Medicare beneficiaries
608
Total services
6,888
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
68%
CMS beneficiary-panel share
Diabetes
24%
CMS beneficiary-panel share
Anxiety
23%
CMS beneficiary-panel share
Ischemic heart disease
22%
CMS beneficiary-panel share
Osteoporosis
22%
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.
| CMS service description | Services | Avg allowed |
|---|---|---|
| Injection, denosumab, 1 mg | 2,700 | $25.70 |
| Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 722 | $124.35 |
| Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 237 | $86.62 |
| Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 164 | $127.30 |
| Influenza vaccine, trivalent derived from recombinant dna | 94 | $80.95 |
| Injection of drug or substance under skin or into muscle | 87 | $13.81 |
| Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 37 | $288.85 |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 37 | $13.79 |
| Transitional care management services for problem of high complexity | 37 | $271.61 |
| Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic | 37 | $13.63 |
Where these Part D numbers come from, and what they cannot tell you
CMS data reports historical prescription drug events attributed to NPI 1013968577. Formularies, copays, prior authorization, and step therapy rules vary by current coverage.
| Rank | Drug | Generic name | Total claims | 30-day fills | Total drug cost |
|---|---|---|---|---|---|
| 1 | Rosuvastatin Calcium | Rosuvastatin Calcium | 275 | 709.6 | $2,684.06 |
| 2 | Atorvastatin Calcium | Atorvastatin Calcium | 232 | 600 | $2,542.06 |
| 3 | Amlodipine Besylate | Amlodipine Besylate | 217 | 518.6 | $946.48 |
| 4 | Levothyroxine Sodium | Levothyroxine Sodium | 214 | 558 | $2,004.22 |
| 5 | Metformin Hcl | Metformin Hcl | 213 | 497.7 | $1,615.45 |
| 6 | Duloxetine Hcl | Duloxetine Hcl | 210 | 442 | $3,767.59 |
| 7 | Losartan Potassium | Losartan Potassium | 206 | 492.4 | $1,919.63 |
| 8 | Tamsulosin Hcl | Tamsulosin Hcl | 196 | 445 | $2,832.58 |
| 9 | Pantoprazole Sodium | Pantoprazole Sodium | 184 | 388 | $2,127.63 |
| 10 | Carvedilol | Carvedilol | 168 | 360.5 | $967.80 |
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.
Medical school
University Of Virginia School Of Medicine
Graduation year
1980
Group/practice field
South Hills Family Medicine, Llc
Telehealth reported
Yes
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.
The numbers above come from CMS public-use files for this NPI. Each link identifies the CMS release used and the retrieval date.