PRANAY KATHURIA MD FACP
NPI 1073583431
Internal Medicine - Nephrology in Tulsa, OK
Active since January 26, 2006PECOS EnrolledAccepts Medicare Assignment
13.16/100
CMS Quality Rating
About Pranay Kathuria Md Facp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRANAY KATHURIA MD FACP (NPI 1073583431) is an individual nephrology provider in Tulsa, Oklahoma, licensed in Oklahoma (20384) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Saint Francis Hospital Muskogee, and is a graduate of Other (1987).
NPPES Registry Identity
NPI1073583431
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NamePRANAY KATHURIACredential: MD FACP
Location Address591 E 36TH ST NTulsa, OK 74106-1812
Mailing AddressPo Box 268838Oklahoma City, OK 73126-8838 · (918) 619-4400 · Fax (918) 619-4591
Phone(918) 619-4400
Fax(918) 619-4591
Sole ProprietorNo
Medical School CMSOtherGraduated 1987
Enumeration DateJanuary 26, 2006
Last NPPES UpdateMarch 24, 2016
✔ NPI 1073583431 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in OK · 20384
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
591 E 36TH ST N, Tulsa, OK 74106
Other Identifiers 2
Medicare PIN243415504OK
Medicaid100257970COK
Accepted Insurance
The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan 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
Pranay Kathuria Md Facp 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 ID8921080896
PECOS Enrollment IDI20040603001160
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 14
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.
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
611 services216 patients
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.
512 services273 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
445 services156 patients
Dialysis services, 2-3 physician visits per month (20 years or older) 90961
Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.
220 services53 patients
Home dialysis services per month (20 years or older) 90966
Home dialysis services provide kidney treatment for patients aged 20 or older right in their own homes. This service includes necessary equipment, supplies, and support for performing dialysis. It's a convenient option that allows patients to maintain their daily routines while receiving essential care.
157 services27 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
138 services125 patients
Hospital Affiliations CMS Care Compare 5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Saint Francis Hospital Muskogee
Acute Care Hospitals · Muskogee, OKOwnershipVoluntary non-profit - Private
CMS Certification Number370025
Location300 Rockefeller DriveMuskogee, OK 74401 · Muskogee County
Emergency services Birthing friendly
Ascension St John Medical Center
Acute Care Hospitals · Tulsa, OKOwnershipVoluntary non-profit - Private
CMS Certification Number370114
Location1923 South Utica AvenueTulsa, OK 74104 · Tulsa County
Emergency services Birthing friendly
Cherokee Nation W W Hastings Indian Hospital
Acute Care Hospitals · Tahlequah, OKOwnershipVoluntary non-profit - Other
CMS Certification Number370171
Location100 S Bliss AvenueTahlequah, OK 74464 · Cherokee County
Emergency services Birthing friendly
Ascension St John Broken Arrow
Acute Care Hospitals · Broken Arrow, OKOwnershipVoluntary non-profit - Private
CMS Certification Number370235
Location1000 West Boise CircleBroken Arrow, OK 74012 · Tulsa County
Emergency services
Ascension St John Sapulpa
Critical Access Hospitals · Sapulpa, OKOwnershipVoluntary non-profit - Private
CMS Certification Number371312
Location1004 East BryanSapulpa, OK 74066 · Creek County
Emergency services
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 74106 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
$123.06 typical visit price
range $53.00 – $162.61
Typical copayment $30.76 (range $13.25 – $40.65)
Most-billed visit code 99204
Established Patient
$94.27 typical visit price
range $16.68 – $132.40
Typical copayment $23.56 (range $4.17 – $33.10)
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.
13.16/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scoredQuality
0
Promoting Interoperability
0
Improvement Activities
0
Cost
43.88
Reported Quality Measures
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
19%172 patients1/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
20%113 patients
Clinical Information Reconciliation
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation.
43%46 patients2/55-star benchmark: 96%
Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
49%136 patients3/55-star benchmark: 95%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
26%380 patients2/55-star benchmark: 85%
Depression Utilization of the PHQ-9 Tool
The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit
Patients 4MonthsOfEnd: 6% · 65 patients
5%64 patients
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
17%203 patients1/55-star benchmark: 100%
Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
14%203 patients1/55-star benchmark: 98%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
100%203 patients5/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
98%1,763 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
93%595 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
4%375 patients1/55-star benchmark: 99%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…
1%346 patients1/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
20%375 patients1/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
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…
20%649 patients1/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
17%494 patients1/55-star benchmark: 88%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
0%571 patients1/55-star benchmark: 96%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
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
Patients screenedForUse: 78% · 544 patients
Patients tobacco: 73% · 544 patients
31%39 patients2/55-star benchmark: 98%
Provide Patient Access
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…
25%346 patients2/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in…
29%346 patients2/55-star benchmark: 99%
Send a Summary of Care
For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider-(1) creates a summary of care record using certified EHR technology; and (2)…
100%47 patients5/55-star benchmark: 99%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: - Adults aged >= 21 years who were previously diagnosed with or currently have an active…
82%265 patients4/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 3% · 375 patients
6%375 patients3/55-star benchmark: 100%
Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.
60%45 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.
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.
Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg J7503
Treatment-Chemotherapy · category RH002N
2 suppliers24 claims4,200 services$1.18 avg. paid by Medicare
Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
8 suppliers88 claims7,533 services$0.30 avg. paid by Medicare
Prednisone, immediate release or delayed release, oral, 1 mg J7512
Treatment-Treatment - Miscellaneous · category RX029N
4 suppliers37 claims5,550 services$0.01 avg. paid by Medicare
Mycophenolate mofetil, oral, 250 mg J7517
Treatment-Treatment - Miscellaneous · category RX029N
5 suppliers35 claims7,800 services$0.18 avg. paid by Medicare
Mycophenolic acid, oral, 180 mg J7518
Treatment-Treatment - Miscellaneous · category RX029N
4 suppliers32 claims3,000 services$0.93 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
9 suppliers74 claims74 services$17.66 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Social Worker (Clinical)
591 E 36TH ST N, STE 200
TULSA, OK 74106
TULSA, OK 74106
Pediatrics
591 E 36TH ST N
TULSA, OK 74106
TULSA, OK 74106
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 Pranay Kathuria's NPI number?
The NPI number for Pranay Kathuria is 1073583431. It was assigned to this individual provider in the NPPES registry on January 26, 2006.
Where is Pranay Kathuria located?
Pranay Kathuria practices at 591 E 36th St N, Tulsa, OK 74106. The listed phone number is (918) 619-4400.
What is Pranay Kathuria's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.
Is Pranay Kathuria enrolled in Medicare?
Yes. Pranay Kathuria 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 Pranay Kathuria accept?
Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 5 other insurers list Pranay Kathuria 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 Pranay Kathuria affiliated with any hospitals?
According to CMS data, Pranay Kathuria is affiliated with Saint Francis Hospital Muskogee, Ascension St John Medical Center, Cherokee Nation W W Hastings Indian Hospital, Ascension St John Broken Arrow and Ascension St John Sapulpa.
When was this NPI record last updated?
The NPPES record for Pranay Kathuria was last updated on March 24, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.
