DR. NIRAJ V PAREKH
NPI 1043416498
Internal Medicine - Interventional Cardiology in Riverside, CA

Quality Rating: 75 out of 100 score

NPI Status: Active since June 22, 2007

Contact Information

3770 ELIZABETH ST
RIVERSIDE, CA
ZIP 92506
Phone: (951) 352-3937
Fax: (951) 352-2839

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Table of Contents

NPI Profile Information
Primary Taxonomy
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Overall Quality Performance
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 19
Internal Medicine
Interventional Cardiology
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About NIRAJ PAREKH

This page provides the complete NPI Profile along with additional information for Niraj Parekh, an internist established in Riverside, California with a medical specialization in Internal Medicine, focusing in interventional cardiology and more than 19 years of experience. The healthcare provider is registered in the NPI registry with number 1043416498 assigned on June 2007. The practitioner's primary taxonomy code is 207RI0011X with license number A106262 (CA). The provider is registered as an individual and his NPI record was last updated 9 years ago.

NPI: 1043416498
Provider Name: DR. NIRAJ V PAREKH
Gender: Male
Entity Type: Individual
Location Address: 3770 ELIZABETH ST RIVERSIDE, CA 92506
Location Phone: (951) 352-3937
Location Fax: (951) 352-2839
Mailing Address: 3770 ELIZABETH ST. RIVERSIDE, CA 92506
Mailing Phone: (951) 352-3937
Mailing Fax: (951) 352-2839
Medical School Name: OTHER
Graduation Year: 2007
Is Sole Proprietor?: No
Enumeration Date: 06-22-2007
Last Update Date: 01-09-2017
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An internist like Niraj Parekh is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Internal Medicine Interventional Cardiology
Taxonomy Code: 207RI0011X
Type: Allopathic & Osteopathic Physicians
License No.: A106262
License State: CA
Taxonomy Description: An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.

Medicare Participation & PECOS Enrollment Status

Niraj Parekh is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Niraj Parekh 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.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 3870635501
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20100119000580
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
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 to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic
Coronary angioplasty and stenting
Established patient office or other outpatient visit, 30-39 minutes
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician
External shock to heart to regulate heart beat
Follow-up hospital inpatient care per day, typically 25 minutes
Initial hospital inpatient care per day, typically 70 minutes
Initial hospital observation care per day, typically 50 minutes
Initial hospital observation care per day, typically 70 minutes
Injection, regadenoson, 0.1 mg
Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch
Insertion of tube in coronary artery for diagnosis with review by radiologist
Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist
Insertion of tube in pulmonary artery for monitoring
Insertion of tube in right and left heart chambers and coronary artery for diagnosis with review by radiologist
Insertion of tube into abdominal, pelvic, or leg artery, initial third order branch
Insertion of tube into artery for drug infusion for blood clot with review by radiologist, initial treatment day
Insertion of tube into left or right pulmonary artery
Leg revascularization (restoring blood flow)
New patient office or other outpatient visit, 45-59 minutes
Nuclear medicine studies of heart muscle at rest and with stress and spect
Nuclear medicine studies of heart muscle at rest and with stress and spect
Pacemaker insertion or repair
Removal of plaque, insertion of stent and balloon dilation of single coronary artery or branch
Repair of left upper heart chamber with implant with review by radiologist
Replacement of aortic valve through the skin and femoral artery
Review by radiologist of abdominal aorta image
Review by radiologist of arm or leg artery image
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
Technetium tc-99m sestamibi, diagnostic, per study dose
Ultrasonic guidance for blood vessel access
Ultrasound of both sides of head and neck blood flow
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
Ultrasound of heart with probe in esophagus, with report
Ultrasound study of arm or leg veins with compression and maneuvers
Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $34.01 for a new patient copayment and $26.16 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 92506 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $136.04
Minimum New Patient Price $59.6
Maximum New Patient Price $179.42

Average New Patient Copayment $34.01
Minimum New Patient Copayment $14.9
Maximum New Patient Copayment $44.85

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $104.64
Minimum Established Patient Price $19.37
Maximum Established Patient Price $146.42

Average Established Patient Copayment $26.16
Minimum Established Patient Copayment $4.84
Maximum Established Patient Copayment $36.6

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 75, 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 Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS 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.

Final Score: 75 out of 100

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.
Quality Score: N/A

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 Score: 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 Score: N/A

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 activities measure category compromises 15% providers final MPIS scores.

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 Score: 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.
Cost Score: 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.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
e-Prescribing	100%	24
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Immunization Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data.
Medication Reconciliation	53%	195
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education	1%	565
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	100%	205
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 encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Provide Patient Access	41%	565
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1043416498, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 8

Pos 4

Unchanged

Pos 5

Doubled → 8

Pos 6

Unchanged

Pos 7

Doubled → 12 → 1 + 2

Pos 8

Unchanged

Pos 9

Doubled → 18 → 1 + 8

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 4 → 8 6 → 12 → 3 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 8 + 3 + 8 + 1 + 1 + 2 + 4 + 1 + 8 + 24 = 62

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8

This NPI is valid

The calculated check digit is 8, which matches the last digit of 1043416498.