Blerta Lici Gaqi, DO
Opted out of Medicare from February 2024 to February 2028. Family Medicine (DO) in Waterford, Michigan, licensed in MI, with an NPI issued in February 2017. Their prescriptions cost Medicare Part D more than their services did: $400,299 for 3,120 claims, against $854.30 paid for services in 2024. Pfizer Inc. reported $125.00 in payments in 2025, mostly food and beverage.
Overview
| NPI | 1588103865 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DO |
| Sole proprietor | Yes |
| NPI issued | Feb 19, 2017 |
| Last updated in NPPES | Apr 19, 2024 |
| Certified by provider | Apr 19, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | 5101023213 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|---|
| Opt-out | Opted out Feb 21, 2024 – Feb 21, 2028 |
| Can order and refer | No |
| Accepts assignment | Yes (participating) |
During an opt-out period the provider sees Medicare patients only under private contracts, and Medicare does not pay claims for their services.
Medicare services in 2024
| Medicare patients | 23 |
|---|---|
| Services billed | 35 across 10 procedure codes |
| Paid by Medicare | $854.30 |
Part D prescriptions in 2024
| Prescriptions (claims) | 3,120 · 6,636 30-day fills |
|---|---|
| Patients | 317 |
| Total drug cost | $400,299 |
| Generic share | 83% of claims |
Industry payments (Open Payments)
- 2025$125.00 · 1 payment from 1 company
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Pfizer Inc. | $125.00 | 1 |
What the 2025 payments were for
- Food and Beverage$125.00 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 39 family medicine physicians in Waterford · All family medicine physicians in Michigan