SANJAY CHAUDHRY M.D. NPI 1013088228
Specialist in Martins Ferry, OH

About SANJAY CHAUDHRY M.D.

Sanjay Chaudhry is a provider established in Martins Ferry, Ohio and his medical specialization is Specialist with more than 36 years of experience. He graduated from Medical College Of Pennsylvania in 1987. The NPI number of Sanjay Chaudhry is 1013088228 and was assigned on November 2006. The practitioner's primary taxonomy code is 174400000X with license number 35062737C (OH). The provider is registered as an individual and his NPI record was last updated 15 years ago.

NPI
1013088228
Provider Name SANJAY CHAUDHRY M.D.
Location Address92 N 4TH ST SUITE 11 MARTINS FERRY, OH 43935
Location Phone(740) 633-4447
Mailing Address92 N 4TH ST SUITE 11 MARTINS FERRY, OH 43935
GenderMale
NPI Entity TypeIndividual
Medical School NameMEDICAL COLLEGE OF PENNSYLVANIA
Graduation Year1987
Is Sole Proprietor?No
Enumeration Date11-10-2006
Last Update Date07-08-2007

Sanjay Chaudhry is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Sanjay Chaudhry is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with East Ohio Regional Hospital, Reynolds Memorial Hospital, Wheeling Hospital and Barnesville Hospital Association, Inc.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 69.5, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance. The provider also has detailed performance information the following quality measures: colorectal cancer screening, implementation of improvements that contribute to more timely communication of test results, implementation of use of specialist reports back to referring clinician or group to close referral loop, preventive care and screening: body mass index (bmi) screening and follow-up plan and preventive care and screening: tobacco use: screening and cessation intervention.



Primary Taxonomy

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Taxonomy Code174400000X
ClassificationSpecialist
TypeOther Service Providers
License No.35062737C
License StateOH
Taxonomy DescriptionAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting insurance plans from the following companies or healthcare programs:

  • Medicaid
  • Medicare

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Business Address

SANJAY CHAUDHRY M.D.
92 N 4TH ST
SUITE 11
MARTINS FERRY, OH
ZIP 43935
Phone: (740) 633-4447
Fax: (740) 633-4250

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Mailing Address

SANJAY CHAUDHRY M.D.
92 N 4TH ST
SUITE 11
MARTINS FERRY, OH
ZIP 43935
Phone: (740) 633-4447
Fax: (740) 633-4250


Location Map

PECOS Enrollment and Medicare Participation Status

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID6901890060
PECOS Enrollment IDI20040614000403, I20040614000462
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

MIPS Measure Score Weight Score
Quality 40% 61.6
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability (PI) 25% N/A
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities 15% 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost 20% N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
MIPS Final Score - 69.5
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

MIPS Quality Measures

The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.

Quality Measure Performance Number of Patients
Colorectal Cancer Screening 64% 141
Percentage of patients 50-75 years of age who had appropriate screening for colorectal cancer
Implementation of improvements that contribute to more timely communication of test resultsYesN/A
Timely communication of test results defined as timely identification of abnormal test results with timely follow-up.
Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral LoopYesN/A
Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 27% 224
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounterNormal Parameters: Age 18 years and older BMI => 18.5 and < 25 kg/m2
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 85% 79
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 174Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:43239)
  • 96Biopsy of large bowel using an endoscope (HCPCS:45380)
  • 96Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • 79Removal of polyps or growths of large bowel using an endoscope (HCPCS:45385)
  • 62Diagnostic examination of large bowel using an endoscope (HCPCS:45378)
  • 60Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:43235)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Sanjay Chaudhry is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
EAST OHIO REGIONAL HOSPITAL90 NORTH FOURTH STREET
MARTINS FERRY, OH 43935
(740) 633-4205Acute Care Hospitals360080
REYNOLDS MEMORIAL HOSPITAL800 WHEELING AVE
GLEN DALE, WV 26038
(304) 843-3230Acute Care Hospitals510013
WHEELING HOSPITAL1 MEDICAL PARK
WHEELING, WV 26003
(304) 243-3000Acute Care Hospitals510050
BARNESVILLE HOSPITAL ASSOCIATION, INC639 WEST MAIN STREET
BARNESVILLE, OH 43713
(740) 425-5101Critical Access Hospitals361321

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1174400000XOther Service ProvidersSpecialist18071WVNo

Taxonomy Description: an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
F90449MEDICARE UPIN (02)
0755697MEDICARE ID-TYPE UNSPECIFIED (04)WV
0077693000MEDICAID (05)WV
0755696MEDICARE ID-TYPE UNSPECIFIED (04)OH
0956069MEDICAID (05)OH

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1013088228
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2023081624
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 2 + 3 + 0 + 8 + 1 + 6 + 2 + 4 + 24 = 52
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 52 = 88

The NPI number 1013088228 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 14 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1821098195 SUSAN L MORGAN NP
Individual
Nurse Practitioner (Family)92 N 4TH ST
MARTINS FERRY, OH 43935
(740) 633-6332
1104813369 ASHRAF S BADOUR M.D.
Individual
Psychiatry & Neurology (Neurology)92 N 4TH ST
MARTINS FERRY, OH 43935
(740) 633-4194
1831249705 REYNALDO A DELACRUZ MD
Individual
Internal Medicine92 N 4TH ST SUITE 10
MARTINS FERRY, OH 43935
(740) 633-6345
1275659633JOSEPH A GABIS MD INC
Organization
Internal Medicine (Cardiovascular Disease)92 N 4TH ST
MARTINS FERRY, OH 43935
(740) 633-6462
1356530976WHEELING HOSPITAL, INC.
Organization
Clinic/Center92 N 4TH ST
MARTINS FERRY, OH 43935
(304) 243-3000
1508040858JAMES R SHOPE MD LLC
Organization
Plastic Surgery92 N 4TH ST SUITE A
MARTINS FERRY, OH 43935
(740) 633-4303
1700177961APOLLO MEDICAL MANAGEMENT
Organization
Non-Pharmacy Dispensing Site92 N 4TH ST SUITE 28
MARTINS FERRY, OH 43935
(740) 633-6332
1790757490 BRUCE GARY BLANK DPM
Individual
Podiatrist92 N 4TH ST SUITE 27
MARTINS FERRY, OH 43935
(740) 633-4188
1821298282RENATO F DELACRUZ MD
Organization
Internal Medicine92 N 4TH ST SUITE 22
MARTINS FERRY, OH 43935
(740) 633-6332
1518060664 MARIO CORDOVA MEJIA MD
Individual
Internal Medicine92 N 4TH ST SUITE 18
MARTINS FERRY, OH 43935
(740) 633-4305
1699215749ALECTO EAST OHIO PHYSICIANS, INC.
Organization
Family Medicine92 N 4TH ST SUITE 11
MARTINS FERRY, OH 43935
(740) 633-1100
1427045285 WILLIAM BAILER M.D.
Individual
Surgery92 N 4TH ST SUITE 14
MARTINS FERRY, OH 43935
(740) 633-6504
1023126307DR MARIO C MEJIA PC
Organization
Internal Medicine92 N 4TH ST SUITE 18
MARTINS FERRY, OH 43935
(740) 633-4305
1346961745 JACEY M DUFFY PMHNP-BC
Individual
Nurse Practitioner (Psychiatric/Mental Health)92 N 4TH ST
MARTINS FERRY, OH 43935
(740) 213-3153

Frequently Asked Questions

What is Sanjay Chaudhry M.D. NPI number?

The NPI number assigned to Sanjay Chaudhry M.D. is 1013088228, registered as an "individual" on November 10, 2006

Where is Sanjay Chaudhry M.D. located?

The provider is located at 92 N 4th St Suite 11 Martins Ferry, Oh 43935 and the phone number is (740) 633-4447

Which is Sanjay Chaudhry M.D. specialty?

The provider's speciality is Specialist

How many years of experience does Sanjay Chaudhry M.D. have?

The provider has more than 36 years of experience. He graduated from Medical College Of Pennsylvania in 1987.

What insurance does Sanjay Chaudhry M.D. accept?

The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your insurance plan is currently accepted.

Is Sanjay Chaudhry M.D. registered in PECOS?

Yes, as of November 14, 2022 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What are some of the services provided by Sanjay Chaudhry M.D.?

The most common procedures or services performed by this practitioner are: Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope, Biopsy of large bowel using an endoscope, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Removal of polyps or growths of large bowel using an endoscope, Diagnostic examination of large bowel using an endoscope and Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope.

Is Sanjay Chaudhry M.D. affiliated to any hospitals?

The practitioner is affiliated to the following hospitals: EAST OHIO REGIONAL HOSPITAL, REYNOLDS MEMORIAL HOSPITAL, WHEELING HOSPITAL and BARNESVILLE HOSPITAL ASSOCIATION, INC. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

How do I update my NPI information?

The NPI record of Sanjay Chaudhry M.D. was last updated on November 10, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]