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DR. PHANI R NIMMAGADDA M.D
NPI 1104813401
Internal Medicine in Smithtown, NY

Active since October 02, 2005PECOS Enrolled
91.25/100
CMS Quality Rating
12 MANOR RD, SMITHTOWN, NY 11787(631) 724-4110(631) 366-2669 Get Directions Write a Review

NPPES record last updated: January 6, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Phani R Nimmagadda M.d NPPES

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

DR. PHANI R NIMMAGADDA M.D (NPI 1104813401) is an individual internal medicine provider in Smithtown, New York, licensed in New York (201565-1) and active in the NPI registry since October 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104813401
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. PHANI R NIMMAGADDACredential: M.D
Location Address12 MANOR RDSmithtown, NY 11787-2715
Mailing Address12 Manor RdSmithtown, NY 11787-2715 · (631) 724-4110 · Fax (631) 366-2669
Phone(631) 724-4110
Fax(631) 366-2669
Sole ProprietorYes
Enumeration DateOctober 2, 2005
Last NPPES UpdateJanuary 6, 2010
✔ NPI 1104813401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NY · 201565-1
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.
12 MANOR RD, Smithtown, NY 11787
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Phani R Nimmagadda M.d is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11787 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
$154.28 typical visit price
range $67.40 – $203.53
Typical copayment $38.57 (range $16.85 – $50.88)
Most-billed visit code 99204
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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.

91.25/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality74.92
Promoting Interoperability91.67
Improvement Activities40

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 Phani Nimmagadda's NPI number?

The NPI number for Phani Nimmagadda is 1104813401. It was assigned to this individual provider in the NPPES registry on October 2, 2005.

Where is Phani Nimmagadda located?

Phani Nimmagadda practices at 12 Manor Rd, Smithtown, NY 11787. The listed phone number is (631) 724-4110.

What is Phani Nimmagadda's specialty?

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

Is Phani Nimmagadda enrolled in Medicare?

Yes. Phani Nimmagadda is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Phani Nimmagadda was last updated on January 6, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.