NEETA TRIPATHI MD
NPI 1164492385
Internal Medicine - Cardiovascular Disease in Newark, DE

NPI Status: Active since January 23, 2006

Contact Information

4755 OGLETOWN STANTON RD STE 1070
NEWARK, DE
ZIP 19718
Phone: (302) 733-1663
Fax: (302) 733-1616

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Years of Experience 38
Internal Medicine
Cardiovascular Disease
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About NEETA TRIPATHI

This page provides the complete NPI Profile along with additional information for Neeta Tripathi, an internist established in Newark, Delaware with a medical specialization in Internal Medicine, focusing in cardiovascular disease and more than 38 years of experience. The healthcare provider is registered in the NPI registry with number 1164492385 assigned on January 2006. The practitioner's primary taxonomy code is 207RC0000X with license number C1-0026310 (DE). The provider is registered as an individual and her NPI record was last updated 3 years ago.

NPI: 1164492385
Provider Name: NEETA TRIPATHI MD
Gender: Female
Entity Type: Individual
Location Address: 4755 OGLETOWN STANTON RD STE 1070 NEWARK, DE 19718
Location Phone: (302) 733-1663
Location Fax: (302) 733-1616
Mailing Address: 4755 OGLETOWN STANTON RD STE 1070 NEWARK, DE 19718
Mailing Phone: (302) 733-1663
Mailing Fax: (302) 733-1616
Medical School Name: OTHER
Graduation Year: 1988
Is Sole Proprietor?: No
Enumeration Date: 01-23-2006
Last Update Date: 10-16-2023
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An internist like Neeta Tripathi 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.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Internal Medicine Cardiovascular Disease
Taxonomy Code: 207RC0000X
Type: Allopathic & Osteopathic Physicians
License No.: C1-0026310
License State: DE
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	207RC0000X	Allopathic & Osteopathic Physicians	Internal Medicine Cardiovascular Disease	25MA06877000 (NJ)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Ambetter from Home State Health

Complete Gold - EPO
Complete Gold + Vision + Adult Dental - EPO
Complete Silver - EPO
Complete Silver + Vision + Adult Dental - EPO
Elite Bronze - EPO
Elite Bronze + Vision + Adult Dental - EPO
Everyday Bronze - EPO
Everyday Bronze + Vision + Adult Dental - EPO
Everyday Gold - EPO
Everyday Gold + Vision + Adult Dental - EPO

Ambetter from NH Healthy Families

Choice Bronze HSA - EPO
Choice Bronze HSA + Vision + Adult Dental - EPO
Clear Silver - EPO
Clear Silver + Vision + Adult Dental - EPO
Complete Gold - EPO
Complete Gold + Vision + Adult Dental - EPO
Complete Silver - EPO
Complete Silver + Vision + Adult Dental - EPO
Elite Bronze - EPO
Elite Bronze + Vision + Adult Dental - EPO

Ambetter from Sunflower Health Plan

Elite Bronze - EPO
Elite Bronze + Vision + Adult Dental - EPO
Elite Gold - EPO
Elite Gold + Vision + Adult Dental - EPO
Everyday Bronze - EPO
Everyday Bronze + Vision + Adult Dental - EPO
Everyday Gold - EPO
Everyday Gold + Vision + Adult Dental - EPO
Focused Silver - EPO
Focused Silver + Vision + Adult Dental - EPO

Ambetter Health

Choice Bronze HSA - EPO
Choice Bronze HSA + Vision + Adult Dental - EPO
Clear Gold - EPO
Clear Gold + Vision + Adult Dental - EPO
Complete Gold - HMO
Complete Gold + Vision + Adult Dental - HMO
Elite Bronze - EPO
Elite Bronze - HMO
Elite Bronze + Vision + Adult Dental - EPO
Elite Bronze + Vision + Adult Dental - HMO

Ambetter Health of Delaware

Clear Gold - EPO
Clear Gold + Vision + Adult Dental - EPO
Complete Gold - EPO
Complete Gold + Vision + Adult Dental - EPO
Elite Silver - EPO
Elite Silver + Vision + Adult Dental - EPO
Everyday Bronze - EPO
Everyday Bronze + Vision + Adult Dental - EPO
Focused Silver - EPO
Focused Silver + Vision + Adult Dental - EPO

Highmark Blue Cross Blue Shield Delaware

my Blue Access Major Events Select PPO Catastrophic 10600 - 3 Free PCP Visits - PPO
my Blue Access Select PPO Bronze 3800 - PPO
my Blue Access Select PPO Bronze 3800 + Adult Dental and Vision - PPO
my Blue Access Select PPO Bronze 9200 - PPO
my Blue Access Select PPO Gold 0 - PPO
my Blue Access Select PPO Gold 0 + Adult Dental and Vision - PPO
my Blue Access Select PPO Gold 1700 HSA - PPO
my Blue Access Select PPO Premier Gold 0 + Adult Dental and Vision - PPO
my Blue Access Select PPO Premier Platinum 0 + Adult Dental and Vision - PPO
my Blue Access Select PPO Premier Silver 0 + Adult Dental and Vision - PPO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
8172901	MEDICAID (05)	NJ
22-3052989	OTHER (01)	NJ	TAX ID

Medicare Participation & PECOS Enrollment Status

Neeta Tripathi is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Neeta Tripathi is enrolled in PECOS and is eligible to order or refer health care 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.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 2860419322
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20230830002209
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
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 to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Anticoagulant management of patient taking warfarin
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month
Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Injection, aminophyllin, up to 250 mg
Injection, regadenoson, 0.1 mg
Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes
Nuclear medicine studies of heart muscle at rest and with stress and spect
Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
Smoking and tobacco use intensive counseling, 4-10 minutes
Technetium tc-99m tetrofosmin, diagnostic, per study dose
Ultrasound of both sides of head and neck blood flow
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
Ultrasound of leg arteries or artery grafts
Ultrasound study of arm and leg arteries
Ultrasound study of arm or leg veins with compression and maneuvers

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.78 for a new patient copayment and $17.79 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 19718 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $131.15
Minimum New Patient Price $57.12
Maximum New Patient Price $173.08

Average New Patient Copayment $32.78
Minimum New Patient Copayment $14.28
Maximum New Patient Copayment $43.27

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $71.19
Minimum Established Patient Price $18.36
Maximum Established Patient Price $141.05

Average Established Patient Copayment $17.79
Minimum Established Patient Copayment $4.59
Maximum Established Patient Copayment $35.26

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. 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	Number of Patients
Chronic Care and Preventative Care Management for Empaneled Patients	Yes	N/A
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
Engagement of patients through implementation of improvements in patient portal	Yes	N/A
Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence.
Implementation of formal quality improvement methods, practice changes, or other practice improvement processes	Yes	N/A
Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following such as: • Multi-Source Feedback; • Train all staff in quality improvement methods; • Integrate practice change/quality improvement into staff duties; • Engage all staff in identifying and testing practices changes; • Designate regular team meetings to review data and plan improvement cycles; • Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff; and/or • Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data.
Implementation of improvements that contribute to more timely communication of test results	Yes	N/A
Timely communication of test results defined as timely identification of abnormal test results with timely follow-up.
Implementation of medication management practice improvements	Yes	N/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral Loop	Yes	N/A
Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology.
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record	Yes	N/A
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.
Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms.	Yes	N/A
Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms.
Tobacco use	Yes	N/A
Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence.
Use of decision support and standardized treatment protocols	Yes	N/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1164492385, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 12 → 1 + 2

Pos 4

Unchanged

Pos 5

Doubled → 8

Pos 6

Unchanged

Pos 7

Doubled → 4

Pos 8

Unchanged

Pos 9

Doubled → 16 → 1 + 6

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 4 → 8 2 → 4 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 2 + 4 + 8 + 9 + 4 + 3 + 1 + 6 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5

This NPI is valid

The calculated check digit is 5, which matches the last digit of 1164492385.