UTPAL K BHANJA MD
NPI 1003801689
Internal Medicine - Hematology & Oncology in Gallipolis, OH

Active since September 20, 2005PECOS EnrolledAccepts Medicare Assignment
81.42/100
CMS Quality Rating
170 JACKSON PIKE, GALLIPOLIS, OH 45631(855) 446-5937(740) 446-5622 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 7, 2023, Feb 11, 2021, Mar 14, 2019 and 1 more (4 updates tracked since 2015).

About Utpal K Bhanja Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UTPAL K BHANJA MD (NPI 1003801689) is an individual hematology & oncology provider in Gallipolis, Ohio, licensed in Ohio (35067633B) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Holzer Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1003801689
Entity TypeIndividualMale
Primary Taxonomy207RH0003X
Provider Legal NameUTPAL K BHANJACredential: MD
Location Address170 JACKSON PIKEGallipolis, OH 45631-1539
Mailing Address90 Jackson PikeGallipolis, OH 45631-1560 · (740) 446-5000
Fax(740) 446-5622
Sole ProprietorYes
Medical School CMSOtherGraduated 1982
Enumeration DateSeptember 20, 2005
Last NPPES UpdateMarch 7, 20234 updates tracked since enumeration
NPPES CertifiedFebruary 11, 2021
NPI 1003801689 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
License Licensed in OH · 35067633B
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
170 JACKSON PIKE, Gallipolis, OH 45631

Secondary Practice Locations 2

Location 1210 Marie Langdon DrManchester, KY 40962-6388 · Phone (606) 598-5104 · Fax (606) 598-0983
Location 2515 Memorial Dr Ste 1Manchester, KY 40962-9157 · Phone (606) 598-4500 · Fax (606) 599-2540

Other Identifiers 3

Medicaid7100567180KY
Medicaid0076262001WV
Medicaid0996605OH

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Utpal K Bhanja Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2163410457
PECOS Enrollment IDI20040505000244
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
151 services105 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
33 services33 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Holzer Medical Center

Acute Care Hospitals · Gallipolis, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360054
Location100 Jackson PikeGallipolis, OH 45631 · Gallia County
Emergency services Birthing friendly

Holzer Medical Center Jackson

Critical Access Hospitals · Jackson, OH
OwnershipVoluntary non-profit - Private
CMS Certification Number361320
Location500 Burlington RoadJackson, OH 45640 · Jackson County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45631 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$166.65 typical visit price
range $54.34 – $166.65
Typical copayment $41.66 (range $13.58 – $41.66)
Most-billed visit code 99205
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.42/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality69.28
Promoting Interoperability100
Improvement Activities40
Cost57.96

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) A4221
DME-Other DME · category DE017N
1 supplier12 claims12 services$19.55 avg. paid by Medicare
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) A4222
DME-Medical/Surgical Supplies · category DA000N
1 supplier12 claims12 services$38.06 avg. paid by Medicare
Injection, fluorouracil, 500 mg J9190
Treatment-Chemotherapy · category RH002N
1 supplier12 claims96 services$1.55 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Radiology (Radiation Oncology)
170 JACKSON PIKE
GALLIPOLIS, OH 45631
Physician Assistant
170 JACKSON PIKE
GALLIPOLIS, OH 45631
Internal Medicine (Medical Oncology)
170 JACKSON PIKE
GALLIPOLIS, OH 45631
Radiology (Radiation Oncology)
170 JACKSON PIKE
GALLIPOLIS, OH 45631
Radiology (Radiation Oncology)
170 JACKSON PIKE
GALLIPOLIS, OH 45631
Internal Medicine
170 JACKSON PIKE
GALLIPOLIS, OH 45631
Radiology (Radiation Oncology)
170 JACKSON PIKE
GALLIPOLIS, OH 45631

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Utpal Bhanja's NPI number?

The NPI number for Utpal Bhanja is 1003801689. It was assigned to this individual provider in the NPPES registry on September 20, 2005.

Where is Utpal Bhanja located?

Utpal Bhanja practices at 170 Jackson Pike, Gallipolis, OH 45631. The listed phone number is (855) 446-5937.

What is Utpal Bhanja's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Is Utpal Bhanja enrolled in Medicare?

Yes. Utpal Bhanja is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Utpal Bhanja accept?

Health plans from CareSource and MedMutual list Utpal Bhanja as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Utpal Bhanja affiliated with any hospitals?

According to CMS data, Utpal Bhanja is affiliated with Holzer Medical Center and Holzer Medical Center Jackson.

When was this NPI record last updated?

The NPPES record for Utpal Bhanja was last updated on March 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.