DR. RAJ P VALLABHANENI MD NPI 1124025804

Internal Medicine (Cardiovascular Disease) in Cleveland, OH

NPI 1124025804 Individual Male Years of Experience 34 Internal Medicine Cardiovascular Disease PECOS Enrolled Accepts Medicare Approved Payment Medicare Quality Reporting

About RAJ VALLABHANENI

Raj Vallabhaneni is an internal medicine provider established in Cleveland, Ohio and his medical specialization is internal medicine (cardiovascular disease) with more than 34 years of experience. The NPI number of Raj Vallabhaneni is 1124025804 and was assigned on July 2005. The practitioner's primary taxonomy code is 207RC0000X with license number 35-079676V (OH). The provider is registered as an individual and his NPI record was last updated December 2021.

An internist like Dr. Raj P Vallabhaneni Md 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.

Raj Vallabhaneni is enrolled in PECOS and is eligible to order or refer healthcare 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

Raj Vallabhaneni is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Lake Health, Lake Health Beachwood Medical Center, Metrohealth System, Hillcrest Hospital and University Hospitals Of Cleveland.

The provider participated in Medicare's Quality Payment Program and the following quality measures were reported: care plan, coronary artery disease (cad): antiplatelet therapy, documentation of current medications in the medical record, e-prescribing, implementation of medication management practice improvements, medication reconciliation, onc direct review attestation, onc-acb surveillance attestation (optional), pi bonus for submission of eligible improvement activities using cehrt, preventive care and screening: body mass index (bmi) screening and follow-up plan, preventive care and screening: tobacco use: screening and cessation intervention, preventive care and screening: unhealthy alcohol use: screening & brief counseling, provide 24/7 access to mips eligible clinicians or groups who have real-time access to patient's medical record, provide patient access, security risk analysis, syndromic surveillance reporting and tcpi participation. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

NPI

1124025804

Provider NameDR. RAJ P VALLABHANENI MD
Provider Location Address2500 METROHEALTH DR CLEVELAND, OH 44109
Provider Mailing Address2500 METROHEALTH DR CLEVELAND, OH 44109
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1988
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date07-07-2005
Last Update Date12-27-2021


Primary Taxonomy

Taxonomy Code207RC0000X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationCardiovascular Disease
License No.35-079676V
License StateOH
Taxonomy DescriptionAn 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.

Business Address

DR. RAJ P VALLABHANENI MD
2500 METROHEALTH DR
CLEVELAND, OH
ZIP 44109
Phone: (216) 778-7800

Get Directions


Mailing Address

DR. RAJ P VALLABHANENI MD
2500 METROHEALTH DR
CLEVELAND, OH
ZIP 44109
Phone: (440) 352-4956
Fax: (440) 375-8829



Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
PECOS PAC ID9931011343
PECOS Enrollment IDI20031106000048
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 order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 634Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report (HCPCS:93010)
  • 520Routine EKG using at least 12 leads including interpretation and report (HCPCS:93000)
  • 70Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function (HCPCS:93306)
  • 46Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart (HCPCS:93458)
  • 31Catheter insertion of stents in major coronary artery or branch, accessed through the skin (HCPCS:92928)
  • 18Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician interpretation and report (HCPCS:93018)
  • 14Nuclear medicine study of vessels of heart using drugs or exercise multiple studies (HCPCS:78452)

Quality Reporting

The following quality measures meets Medicare's statistical reporting standards for the year 2018. 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 Rate Number of Patients
Care Plan 96% 623
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan
Coronary Artery Disease (CAD): Antiplatelet Therapy 94% 466
Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease (CAD) seen within a 12 month period who were prescribed aspirin or clopidogrel
Documentation of Current Medications in the Medical Record 100% 1986
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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
e-Prescribing 54% 1104
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Medication Reconciliation 76% 542
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.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 94% 1083
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
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 35% 66
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
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling 75% 582
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
Provide Patient Access 99% 504
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.

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Raj Vallabhaneni is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
LAKE HEALTH7590 AUBURN ROAD
CONCORD, OH 44077
(440) 953-9600Acute Care Hospitals360098
LAKE HEALTH BEACHWOOD MEDICAL CENTER25501 CHAGRIN BLVD
BEACHWOOD, OH 44122
(216) 545-4800Acute Care Hospitals360367
METROHEALTH SYSTEM2500 METROHEALTH DRIVE
CLEVELAND, OH 44109
(216) 778-4196Acute Care Hospitals360059
HILLCREST HOSPITAL6780 MAYFIELD ROAD
MAYFIELD HEIGHTS, OH 44124
(440) 312-4500Acute Care Hospitals360230
UNIVERSITY HOSPITALS OF CLEVELAND11100 EUCLID AVENUE
CLEVELAND, OH 44106
(216) 844-1000Acute Care Hospitals360137

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1174400000XOther Service ProvidersSpecialist35079676VOHNo

Taxonomy Description: an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

2207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease10494NDNo

Taxonomy Description: 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.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
2255009MEDICAID (05)OH

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1992704886 CARIE TWICHELL AA
Individual
Anesthesiologist Assistant2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-4809
1104827740 JULIA A. RILEY PHARM.D.
Individual
Pharmacist2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-1946
1013909209MR. KRISTEN NILS HANSEN RPH
Individual
Pharmacist2500 METROHEALTH DR WOMENS AND CHILDRENS PLAZA
CLEVELAND, OH 44109
(216) 778-8537
1710970082MS. KELLYE KAUFMAN AA-C
Individual
Anesthesiologist Assistant2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-4801
1881687564MR. BRADEN JOSEPH KUNZELMAN RPH
Individual
Pharmacist2500 METROHEALTH DR AMBULATORY PHARMACY
CLEVELAND, OH 44109
(216) 778-7548
1508859281MS. STEPHANIE E CROSS RPH
Individual
Pharmacist2500 METROHEALTH DR OUTPATIENT PHARMACY
CLEVELAND, OH 44109
(216) 778-3017
1255324943MRS. TANIA NICOLE BIERLY RPH
Individual
Pharmacist2500 METROHEALTH DR OUTPATIENT PHARMACY
CLEVELAND, OH 44109
(216) 778-2201
1154315364MR. JOSEPH PEACHMAN A.A.
Individual
Anesthesiologist Assistant2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-4801
1801880596MR. MICHAEL L PYRTKO RPH
Individual
Pharmacist2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-7548
1588658157MS. EBONY NICOLE ALEXANDER RPH
Individual
Pharmacist2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-3017
1275522765 HANS C GEHO M.D.
Individual
Internal Medicine2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-7800
1376523670DR. ANDRE PROCHOROFF MD
Individual
Psychiatry & Neurology (Child & Adolescent Psychiatry)2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-4933
1831166636 SHANE B ROWAN MD
Individual
Internal Medicine (Clinical Cardiac Electrophysiology)2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-2328
1144284928DR. BEN H BROUHARD MD
Individual
Pediatrics (Pediatric Nephrology)2500 METROHEALTH DR ROOM A-109
CLEVELAND, OH 44109
(216) 778-4900
1740246347 SHARI DANIELLE BOLEN M.D.
Individual
Internal Medicine2500 METROHEALTH DR METROHEALTH MEDICAL CENTER-INTERNAL MEDICINE CLINIC
CLEVELAND, OH 44109
(216) 778-2273
1457304255 WILLIAM E CAPPAERT M.D.
Individual
Ophthalmology2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-2236
1316987902 SHARON LYNN MACK CNP
Individual
Nurse Practitioner2500 METROHEALTH DR
CLEVELAND, OH 44109
(216) 778-7800
1770523516MS. ANNETTE M LYNCH MSN, CNS
Individual
Clinical Nurse Specialist (Perinatal)2500 METROHEALTH DR DEPARTMENT OF PEDIATRICS/PERINATAL
CLEVELAND, OH 44109
(216) 778-7800
1427099183DR. KARL G WAGNER MD
Individual
Anesthesiology2500 METROHEALTH DR DEPARTMENT OF ANESTHESIOLOGY
CLEVELAND, OH 44109
(216) 778-4809
1760428155 GRAHAM H CREASEY MD
Individual
Physical Medicine & Rehabilitation (Spinal Cord Injury Medicine)2500 METROHEALTH DR MHMC-PM&R
CLEVELAND, OH 44109
(216) 778-8802

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.