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DR. MADHUKAR PANDYA MD
NPI 1104804400
Internal Medicine - Cardiovascular Disease in Jersey City, NJ

Active since January 06, 2006PECOS EnrolledAccepts Medicare Assignment
20 LINCOLN ST, MADHUKAR PANDYA MD, JERSEY CITY, NJ 07307(201) 963-5009(201) 659-5350 Get Directions Write a Review

NPPES record last updated: July 1, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Madhukar Pandya Md NPPES

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

DR. MADHUKAR PANDYA MD (NPI 1104804400) is an individual cardiovascular disease provider in Jersey City, New Jersey, licensed in New Jersey (MA03978000) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Carepoint Health-christ Hospital, and is a graduate of Other (1979).

NPPES Registry Identity

NPI1104804400
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameDR. MADHUKAR PANDYACredential: MD
Location Address20 LINCOLN ST, MADHUKAR PANDYA MDJersey City, NJ 07307-2933
Mailing Address20 Lincoln St, Madhukar Pandya MdJersey City, NJ 07307-2933 · (201) 963-5009 · Fax (201) 659-5350
Phone(201) 963-5009
Fax(201) 659-5350
Sole ProprietorYes
Medical School CMSOtherGraduated 1979
Enumeration DateJanuary 6, 2006
Last NPPES UpdateJuly 1, 2010
✔ NPI 1104804400 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License✔ Licensed in NJ · MA03978000
Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

20 LINCOLN ST, Jersey City, NJ 07307
Open in Google Maps ↗

Other Identifiers 3

Medicare UPINC55660
Medicare ID-Type UnspecifiedPA454945NJ
Medicaid1884409NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.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

Dr. Madhukar Pandya 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 ID7113950080
PECOS Enrollment IDI20050913000237
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 12

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 nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
340 services12 patients
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.
132 services23 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.
78 services25 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.
53 services28 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
35 services25 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
32 services23 patients

Hospital Affiliations CMS Care Compare

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

Carepoint Health-Christ Hospital

Acute Care Hospitals · Jersey City, NJ
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number310016
Location176 Palisade AveJersey City, NJ 07306 · Hudson County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07307 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
$79.09 typical visit price
range $20.97 – $155.92
Typical copayment $19.77 (range $5.24 – $38.98)
Most-billed visit code 99213
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.

Reported Quality Measures

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
92%60 patients4/55-star benchmark: 98%
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.
80%1,192 patients3/55-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.
80%2,747 patients2/55-star benchmark: 99%
Patient-Specific Education
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.
96%314 patients4/55-star benchmark: 97%
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: 96% · 245 patients
Patients tobacco: 93% · 245 patients
84%38 patients4/55-star benchmark: 98%
Provide Patient Access
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…
100%314 patients5/55-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 CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
93%314 patients5/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
0%314 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 4

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
4 suppliers11 claims24 services$6.72 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress E0295
DME-Hospital Beds · category DB000N
1 supplier11 claims11 services$44.62 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers20 claims20 services$14.03 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
2 suppliers20 claims20 services$62.53 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

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

DR. NOROZE J KHAN MD
Internal Medicine (Infectious Disease)
20 LINCOLN ST
JERSEY CITY, NJ 07307
Hudson County (201) 963-3570

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 Madhukar Pandya's NPI number?

The NPI number for Madhukar Pandya is 1104804400. It was assigned to this individual provider in the NPPES registry on January 6, 2006.

Where is Madhukar Pandya located?

Madhukar Pandya practices at 20 Lincoln St Madhukar Pandya MD, Jersey City, NJ 07307. The listed phone number is (201) 963-5009.

What is Madhukar Pandya's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Madhukar Pandya enrolled in Medicare?

Yes. Madhukar Pandya 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 Madhukar Pandya accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Madhukar Pandya 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 Madhukar Pandya affiliated with any hospitals?

According to CMS data, Madhukar Pandya is affiliated with Carepoint Health-Christ Hospital.

When was this NPI record last updated?

The NPPES record for Madhukar Pandya was last updated on July 1, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.