Gustavo Cumbo Nacheli
Pulmonary Disease · Grand Rapids, MINPI 1013124312
Payments from drug & device makers
What this record shows
This record is dominated by consulting fees: $533,036 of the $723,715 with a category attached, or 73.7%. 21 manufacturers reported payments, led by Johnson & Johnson at 43.3% of the total. 2025 is the largest year on record at $154,401, more than ten times the $10,443 reported in 2019. Among pulmonary disease clinicians in MI with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 648 payments — averaging $1116.84 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Johnson & Johnson$313K
- AstraZeneca$158K
- Medical Device Business Services, Inc.$102K
- Ethicon Endo-surgery Inc.$72K
- GE HealthCare$56K
- Siemens Medical Solutions USA, Inc.$10K
- plus $12K from 15 others
Across 8 payments — averaging $13,617 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- Johnson & Johnson$109K
What the payments were for
- Consulting fees$533,03674%
- Speaking & faculty fees$101,47514%
- Travel & lodging$76,08711%
- Food & beverage$13,1172%
General payments by program year
Who reported the general payments
Companies are grouped under their corporate parent — a single manufacturer often files under several CMS reporting entities. Research and ownership payments are counted separately and are not in this table.
| Company | Payments | Total |
|---|---|---|
| Johnson & Johnson | 264 | $313,366 |
| AstraZeneca | 139 | $158,415 |
| Medical Device Business Services, Inc. | 110 | $102,322 |
| Ethicon Endo-surgery Inc. | 45 | $72,423 |
| GE HealthCare | 20 | $55,701 |
| Siemens Medical Solutions USA, Inc. | 18 | $9,577 |
| Pulmonx Corporation | 23 | $2,919 |
| Regeneron | 2 | $2,437 |
| Regeneron Healthcare Solutions, Inc. | 1 | $1,938 |
| Astrazeneca UK Limited | 1 | $1,860 |
| Auris Health, Inc. | 8 | $1,649 |
| CSA Medical, Inc | 1 | $528 |
| Boston Scientific | 6 | $260 |
| Noah Medical Corporation | 2 | $128 |
| Ambu Inc. | 2 | $51 |
| Mauna Kea Technologies, Inc. | 1 | $50 |
| Pentax Of America, Inc. | 1 | $33 |
| Takeda Pharmaceuticals U.S.A., Inc. | 1 | $17 |
| Sanofi | 1 | $15 |
| Medtronic | 1 | $13 |
| Pinnacle Biologics, Inc | 1 | $12 |
What the payments were tied to
Products named in the reported payments. Only payments of $100 or more are attributed here — the typical reported payment nationally is a meal worth about $16, and listing those product-by-product would be noise.
- Monarch Platform$453,519
- TAGRISSO$91,997
- IMFINZI$64,882
- OEC$55,416
- MONARCH$27,982
- LIBTAYO$4,375
- ZEPHYR ENDOBRONCHIAL VALVE$1,389
- Cios Spin$1,319
- Pulmonx Endobronchial Valve EBV$1,172
- CHARTIS CATHETER$939
- ZEPHYR DELIVERY CATHETER$939
- PULMONX CHARTIS TABLET CONSOLE$939
- Artis icono floor$657
How this compares
$723,715 in reported general payments places this provider in the 95th percentile of 463 pulmonary disease providers in Michigan.
Medicare billing
What this is not: this is the amount Original Medicare Part B allowed for services this provider billed in 2024. It is not their income. It excludes Medicare Advantage — now more than half of all Medicare enrollment — along with Medicaid and all commercial insurance, and it is gross practice revenue before staff, rent, supplies and malpractice premiums. CMS also suppresses any figure covering ten or fewer patients, so low-volume providers appear smaller than they are.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| Albuterol Sulfate HfaAlbuterol Sulfate | 11 | $490 |
Paid to pharmacies, not to this prescriber.
Other pulmonary disease in Grand Rapids
- Reda GirgisGrand Rapids$61K
- Sherry KuoGrand Rapids$30K
- Ashley ScottGrand Rapids$30K
- Anupam KumarGrand Rapids$29K
- Maria Katrina AbrilGrand Rapids$21K
- Paul HarrisGrand Rapids$20K
- Meilan HanAnn Arbor$779K
- Njira LugogoAnn Arbor$741K
- Gary FergusonLivonia$601K
- Justin OldhamAnn Arbor$392K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Billing: Medicare Physician & Other Practitioners, data year 2024. Original Medicare Part B only.
- Identity: NPPES NPI Registry, July 2026.