Nisarg Changawala, MD
Pulmonary Disease · Las Vegas, NVNPI 1639408297
Payments from drug & device makers
What this record shows
The money is spread across several categories — education (53.0%), food and beverage and travel and lodging — rather than concentrated in one kind of arrangement. Intuitive Surgical accounts for 77.4% of it on its own, with 12 other manufacturers making up the rest. Reporting peaked in 2022 at $3,409 and has fallen 79.8% since, to $688 in 2025.
Across 31 payments — averaging $182.59 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Intuitive Surgical$4K
- Noah Medical Corporation$575
- AstraZeneca$179
- Actelion Pharmaceuticals US, Inc.$131
- Takeda Pharmaceuticals U.S.A., Inc.$122
- Pulmonx Corporation$78
- plus $194 from 7 others
What the payments were for
- Travel & lodging$55910%
- Food & beverage$2,10137%
- Education$3,00053%
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 |
|---|---|---|
| Intuitive Surgical | 15 | $4,382 |
| Noah Medical Corporation | 2 | $575 |
| AstraZeneca | 2 | $179 |
| Actelion Pharmaceuticals US, Inc. | 1 | $131 |
| Takeda Pharmaceuticals U.S.A., Inc. | 1 | $122 |
| Pulmonx Corporation | 1 | $78 |
| Exelixis Inc. | 1 | $50 |
| GSK | 2 | $37 |
| Veran Medical Technologies, Inc. | 2 | $32 |
| Bristol Myers Squibb | 1 | $22 |
| Pfizer | 1 | $21 |
| Regeneron Healthcare Solutions, Inc. | 1 | $16 |
| Sanofi | 1 | $16 |
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.
How this compares
$5,660 in reported general payments places this provider in the 70th percentile of 84 pulmonary disease providers in Nevada.
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 |
|---|---|---|
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 652 | $534,143 |
| OfevNintedanib Esylate | 35 | $463,381 |
| HetliozTasimelteon | 16 | $352,906 |
| UptraviSelexipag | 12 | $268,773 |
| LetairisAmbrisentan | 15 | $263,402 |
| Spiriva RespimatTiotropium Bromide | 173 | $133,549 |
| Breo ElliptaFluticasone/Vilanterol | 258 | $132,719 |
| NucalaMepolizumab | 15 | $55,332 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 84 | $55,324 |
| Stiolto RespimatTiotropium Br/Olodaterol Hcl | 88 | $44,234 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 63 | $43,513 |
| Incruse ElliptaUmeclidinium Bromide | 66 | $37,729 |
| Arnuity ElliptaFluticasone Furoate | 56 | $21,915 |
| SymbicortBudesonide/Formoterol Fumarate | 58 | $21,160 |
| Wixela InhubFluticasone Propion/Salmeterol | 79 | $12,751 |
Paid to pharmacies, not to this prescriber.
Companies that both paid and supply prescribed drugs
These companies both reported payments to this provider and make drugs the provider prescribed under Medicare Part D in 2024. For most specialties this overlap is expected — a cardiologist who is paid by a cardiology drugmaker also treats heart disease. It is shown so the reader can see it, not because it implies anything on its own.
| Company | Paid to this provider | Part D cost of their drugs |
|---|---|---|
| GSKTrelegy Ellipta, Breo Ellipta, Nucala, Anoro Ellipta, Incruse Ellipta | $37 | $825,3521,110 claims |
| Actelion Pharmaceuticals US, Inc.Uptravi | $131 | $268,77312 claims |
| AstraZenecaBreztri Aerosphere, Symbicort | $179 | $76,484142 claims |
Reading this fairly. The Part D column is what drug plans and patients paid pharmacies — this provider received none of it, and it reflects how many patients they treat and what those drugs cost. Against peers, this provider's reported payments sit in the 70th percentile of 84 pulmonary disease providers in Nevada.
Other pulmonary disease in Las Vegas
- Arthur RomeroLas Vegas$310K
- Lloyd DelmundoLas Vegas$150K
- Naresh SinghLas Vegas$111K
- Abhishek KumarLas Vegas$74K
- Jerome HruskaLas Vegas$72K
- Vishisht MehtaLas Vegas$22K
- Kamran KhanLas Vegas$17K
- John WojcikLas Vegas$14K
- Walter WilloughbyLas Vegas$10K
- Robert LampertLas Vegas$8K
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.