DR. RAJ P VALLABHANENI MD
NPI 1124025804
Internal Medicine - Cardiovascular Disease in Cleveland, OH

Q: What is Raj Vallabhaneni's NPI number?

The NPI number for Raj Vallabhaneni is 1124025804. It was assigned to this individual provider in the NPPES registry on July 7, 2005.

Q: What is Raj Vallabhaneni's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Raj Vallabhaneni was last updated on December 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since July 07, 2005PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

2500 METROHEALTH DR, CLEVELAND, OH 44109(216) 778-7800 Get Directions Write a Review

NPPES record last updated: December 27, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 7, 2025, Dec 27, 2021 (2 updates tracked since 2021).

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About Dr. Raj P Vallabhaneni Md NPPES

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

DR. RAJ P VALLABHANENI MD (NPI 1124025804) is an individual cardiovascular disease provider in Cleveland, Ohio, licensed in Ohio (35-079676V) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Metrohealth System, and is a graduate of Other (1988).

NPPES Registry Identity

NPI1124025804

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NameDR. RAJ P VALLABHANENICredential: MD

Location Address2500 METROHEALTH DRCleveland, OH 44109-1900

Mailing Address2500 Metrohealth DrCleveland, OH 44109-1900 · (440) 352-4956 · Fax (440) 375-8829

Phone(216) 778-7800

Sole ProprietorNo

Medical School CMSOtherGraduated 1988

Enumeration DateJuly 7, 2005

Last NPPES UpdateDecember 27, 20212 updates tracked since enumeration

✔ NPI 1124025804 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

Licenses✔ Licensed in OH · 35-079676V✔ Licensed in ND · 10494

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.

Also ListedSpecialistTaxonomy 174400000X · License 35079676V (OH)

2500 METROHEALTH DR, Cleveland, OH 44109

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Other Identifiers 1

Medicaid2255009OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Raj P Vallabhaneni 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 ID9931011343

PECOS Enrollment IDI20031106000048, I20110713000624

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.

Medicare Billing Reassignments

Medicare enrollment records show Raj Vallabhaneni reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The Metrohealth System

0.1 mi

Multi-Specialty

2500 METROHEALTH DR
Cleveland, OH 44109

Reassigned Medicare billing, Ohio enrollment
2,147 clinicians in this Medicare group

NPI 1053353896 (216) 957-2442

Dlp Conemaugh Physician Practices LLC

154 mi

Family Medicine

200 W MAIN ST
Ligonier, PA 15658

Reassigned Medicare billing, Pennsylvania enrollment
771 clinicians in this Medicare group

NPI 1588070551 (724) 238-9581

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 22

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.

497 services371 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

318 services238 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

258 services199 patients

Routine electrocardiogram (ecg) using at least 12 leads with tracing 93005

An Electrocardiogram (ECG) is a simple, painless test that records the heart's electrical activity. Using 12 leads attached to your skin, it generates a tracing of your heart rhythm. It helps detect any heart problems by showing the timing and strength of electrical signals passing through each part of your heart.

255 services197 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

234 services199 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

92 services89 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

76 services46 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.

65 services39 patients

Technetium tc-99m tetrofosmin, diagnostic, per study dose A9502

Technetium Tc-99m Tetrofosmin is a radiopharmaceutical used in diagnostic imaging. It helps highlight areas of concern in the heart by emitting signals captured by a special camera. This assists doctors in detecting heart conditions.

56 services28 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

55 services54 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.

47 services44 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.

44 services27 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

42 services40 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

34 services29 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.

33 services33 patients

Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist 93458

This procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.

31 services29 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.

30 services24 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

28 services28 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician 93015

An exercise or drug-induced heart stress test with ECG is a procedure performed by a doctor to assess how your heart responds to exertion. It involves monitoring your heart's electrical activity while you exercise or after medication is given to mimic exercise effects.

28 services28 patients

Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch 92928

This procedure involves placing a small, mesh tube (stent) in your coronary artery to keep it open. A balloon is used to expand the stent and artery, improving blood flow to your heart. It's typically done for a single artery or branch.

15 services13 patients

Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional 93228

An Electrocardiogram (ECG) is a non-invasive test that records the electrical signals in your heart. For up to 30 days, a small device will continuously monitor your heart's activity. A healthcare professional will then review the data and provide a report on your heart's function.

12 services12 patients

Electrocardiogram (ecg) up to 30 days continuous with transmission of patient triggered events with review and report by health care professional 93229

An Electrocardiogram (ECG) is a test that records your heart's electrical activity for up to 30 days. You trigger a transmission if you feel symptoms, which is then reviewed by a healthcare professional. The report helps diagnose heart conditions.

12 services12 patients

Hospital Affiliations CMS Care Compare 4

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

Metrohealth System

Acute Care Hospitals · Cleveland, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number360059

Location2500 Metrohealth DriveCleveland, OH 44109 · Cuyahoga County

Emergency services Birthing friendly

Conemaugh Memorial Medical Center

Acute Care Hospitals · Johnstown, PA

3/5 CMS rating

OwnershipProprietary

CMS Certification Number390110

Location1086 Franklin StreetJohnstown, PA 15905 · Cambria County

Emergency services Birthing friendly

Sharon Regional Health System

Acute Care Hospitals · Sharon, PA

2/5 CMS rating

OwnershipProprietary

CMS Certification Number390211

Location740 East State StreetSharon, PA 16146 · Mercer County

Emergency services

Conemaugh Meyersdale Medical Center

Critical Access Hospitals · Meyersdale, PA

OwnershipProprietary

CMS Certification Number391302

Location200 Hospital DriveMeyersdale, PA 15552 · Somerset County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44109 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

$126.12 typical visit price

range $54.34 – $166.65

Typical copayment $31.53 (range $13.58 – $41.66)

Most-billed visit code 99204

Established Patient

$68.07 typical visit price

range $17.10 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

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.

75/100

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

Individually scored

Reported Quality Measures

Care Plan

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…

96%623 patients4/55-star benchmark: 100%

Coronary Artery Disease (CAD): Antiplatelet Therapy

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

94%466 patients4/55-star benchmark: 100%

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.

100%1,986 patients5/55-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.

54%1,104 patients2/55-star benchmark: 100%

Medication Reconciliation

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.

76%542 patients4/55-star benchmark: 100%

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…

94%1,083 patients4/55-star benchmark: 100%

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

35%66 patients2/55-star benchmark: 100%

Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

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

75%582 patients4/55-star benchmark: 100%

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…

99%504 patients4/55-star benchmark: 100%

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.

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.

AMIR RAZAVI MD

Internal Medicine