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SIMA SURESH PANDEY M.D.
NPI 1043222128
Internal Medicine in Elizabeth, NJ

Active since August 13, 2006PECOS EnrolledAccepts Medicare Assignment
92.93/100
CMS Quality Rating
725 N BROAD ST, ELIZABETH, NJ 07208(908) 351-8989(908) 351-8879 Get Directions Write a Review

NPPES record last updated: July 2, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 2, 2020, May 5, 2020 (2 updates tracked since 2020).

About Sima Suresh Pandey M.d. NPPES

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

SIMA SURESH PANDEY M.D. (NPI 1043222128) is an individual internal medicine provider in Elizabeth, New Jersey, licensed in Georgia (055871) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS, is affiliated with Wellstar Kennestone Regional Medical Center, and maintains a secondary practice location in Alpharetta.

NPPES Registry Identity

NPI1043222128
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameSIMA SURESH PANDEYCredential: M.D.
Location Address725 N BROAD STElizabeth, NJ 07208-2347
Mailing Address4895 Windward Pkwy Ste 202Alpharetta, GA 30004-3850 · (770) 475-0888
Phone(908) 351-8989
Fax(908) 351-8879
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateAugust 13, 2006
Last NPPES UpdateJuly 2, 20202 updates tracked since enumeration
NPPES CertifiedJuly 2, 2020
✔ NPI 1043222128 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in GA · 055871✔ Licensed in NJ · 25MA079850
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
725 N BROAD ST, Elizabeth, NJ 07208
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Secondary Practice Location 1

Location 14895 Windward Pkwy Ste 202Alpharetta, GA 30004-3850 · Phone (770) 475-0888

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.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

Sima Suresh Pandey M.d. 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 ID8123067188
PECOS Enrollment IDI20200408004807
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 5

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.
118 services55 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
52 services52 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
17 services15 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
16 services16 patients
Urinalysis, manual test 81002
A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
12 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Wellstar Kennestone Regional Medical Center

Acute Care Hospitals · Marietta, GA
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110035
Location677 Church StreetMarietta, GA 30060 · Cobb County
Emergency services Birthing friendly

Wellstar Cobb Medical Center

Acute Care Hospitals · Austell, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110143
Location3950 Austell RdAustell, GA 30106 · Cobb County
Birthing friendly

Wellstar North Fulton Hospital

Acute Care Hospitals · Roswell, GA
2/5 CMS rating
OwnershipProprietary
CMS Certification Number110198
Location3000 Hospital BoulevardRoswell, GA 30076 · Fulton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07208 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
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
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.

92.93/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.38
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 5

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

SIMA S. PANDEY, MD, LLC
Clinic/Center (Primary Care)
725 N BROAD ST
ELIZABETH, NJ 07208
Union County (908) 351-8989
DR ARUNA S. PATEL.M.D.LLC
Family Medicine (Adult Medicine)
725 N BROAD ST
ELIZABETH, NJ 07208
Union County (908) 351-8989
DR. BALJIT S SAPPAL M.D.
Internal Medicine
725 N BROAD ST
ELIZABETH, NJ 07208
Union County (908) 351-8989
TEIJ MEDICAL INC.
Internal Medicine
725 N BROAD ST
ELIZABETH, NJ 07208
Union County (908) 351-8989
DR. ARUNA SURESHBHAI PATEL M.D. LLC.
Family Medicine
725 N BROAD ST
ELIZABETH, NJ 07208
Union County (908) 351-8989

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 Sima Pandey's NPI number?

The NPI number for Sima Pandey is 1043222128. It was assigned to this individual provider in the NPPES registry on August 13, 2006.

Where is Sima Pandey located?

Sima Pandey practices at 725 N Broad St, Elizabeth, NJ 07208. The listed phone number is (908) 351-8989.

What is Sima Pandey's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Sima Pandey enrolled in Medicare?

Yes. Sima Pandey 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 Sima Pandey accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Sima Pandey 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 Sima Pandey affiliated with any hospitals?

According to CMS data, Sima Pandey is affiliated with Wellstar Kennestone Regional Medical Center, Wellstar Cobb Medical Center and Wellstar North Fulton Hospital.

When was this NPI record last updated?

The NPPES record for Sima Pandey was last updated on July 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.