DHARMESH BABARIA MD
NPI 1053421206
Internal Medicine - Adolescent Medicine in Eau Claire, WI

Q: What is Dharmesh Babaria's NPI number?

The NPI number for Dharmesh Babaria is 1053421206. It was assigned to this individual provider in the NPPES registry on August 30, 2006.

Q: What is Dharmesh Babaria's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Adolescent Medicine, with taxonomy code 207RA0000X.

Q: When was this NPI record last updated?

The NPPES record for Dharmesh Babaria was last updated on October 5, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 30, 2006PECOS EnrolledAccepts Medicare Assignment

78.85/100

CMS Quality Rating

2116 CRAIG RD, EAU CLAIRE, WI 54701(715) 858-4500 Get Directions Write a Review

NPPES record last updated: October 5, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dharmesh Babaria Md NPPES

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

DHARMESH BABARIA MD (NPI 1053421206) is an individual adolescent medicine provider in Eau Claire, Wisconsin, licensed in Wisconsin (47230) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Marshfield Medical Center, and is a graduate of Other (1994).

NPPES Registry Identity

NPI1053421206

Entity TypeIndividualMale

Primary Taxonomy207RA0000X

Provider Legal NameDHARMESH BABARIACredential: MD

Location Address2116 CRAIG RDEau Claire, WI 54701-6149

Mailing Address1000 N Oak AveMarshfield, WI 54449-5703 · (715) 387-5511

Phone(715) 858-4500

Sole ProprietorNo

Medical School CMSOtherGraduated 1994

Enumeration DateAugust 30, 2006

Last NPPES UpdateOctober 5, 2010

✔ NPI 1053421206 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Adolescent MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RA0000X

License✔ Licensed in WI · 47230

Definition

An internist who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

2116 CRAIG RD, Eau Claire, WI 54701

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Other Identifiers 3

Medicare UPINI18498

Medicare ID-Type Unspecified015211050WI

Medicaid34574800WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, HealthPartners, Medica 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

Dharmesh Babaria 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 ID8224099718

PECOS Enrollment IDI20041019000566

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.

490 services266 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.

86 services72 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.

38 services38 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

33 services32 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.

23 services23 patients

Hospital Affiliations CMS Care Compare 4

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

Marshfield Medical Center

Acute Care Hospitals · Marshfield, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number520037

Location611 St Joseph AveMarshfield, WI 54449 · Wood County

Emergency services Birthing friendly

Marshfield Medical Center - Eau Claire

Acute Care Hospitals · Eau Claire, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520210

Location2310 Craig RdEau Claire, WI 54701 · Eau Claire County

Emergency services Birthing friendly

Marshfield Medical Center - Ladysmith

Critical Access Hospitals · Ladysmith, WI

OwnershipGovernment - Hospital District or Authority

CMS Certification Number521328

Location1200 Port Arthur RdLadysmith, WI 54848 · Rusk County

Emergency services

Mayo Clinic Health System-Red Cedar Inc

Critical Access Hospitals · Menomonie, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number521340

Location2321 Stout RdMenomonie, WI 54751 · Dunn County

Emergency services

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.

78.85/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

66.68

Promoting Interoperability

Improvement Activities

Cost

54.87

Referred Medical Equipment & Supplies CMS DME claims 7

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

9 suppliers39 claims64 services$5.59 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

7 suppliers21 claims21 services$0.86 avg. paid by Medicare

Walker, heavy duty, wheeled, rigid or folding, any type E0149

DME-Other DME · category DE000N

1 supplier11 claims11 services$2.47 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$91.11 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$33.26 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers14 claims14 services$213.76 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 20

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

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