DR. PRADEEP RAI MD
NPI 1184863631
Surgery in Denver, CO

Q: What is the provider's specialty?

The provider's specialty is Surgery with taxonomy code 208600000X.

Active since February 06, 2009PECOS EnrolledAccepts Medicare Assignment

72.27/100

CMS Quality Rating

8181 E TUFTS AVE STE 560, DENVER, CO 80237(866) 990-8622(888) 972-8592 Get Directions Write a Review

NPPES record last updated: August 18, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 10, 2025, Apr 17, 2024, Sep 16, 2021 and 2 more (5 updates tracked since 2018).

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About Dr. Pradeep Rai Md NPPES

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

DR. PRADEEP RAI MD (NPI 1184863631) is an individual surgery provider in Denver, Colorado, licensed in Georgia (003499) and active in the NPI registry since February 2009. He is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1184863631

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameDR. PRADEEP RAICredential: MD

Location Address8181 E TUFTS AVE STE 560Denver, CO 80237-2559

Mailing Address1850 Race StDenver, CO 80206-1116 · (720) 725-1564

Phone(866) 990-8622

Fax(888) 972-8592

Sole ProprietorYes

Medical School CMSOtherGraduated 2000

Enumeration DateFebruary 6, 2009

Last NPPES UpdateAugust 18, 20255 updates tracked since enumeration

NPPES CertifiedAugust 18, 2025

✔ NPI 1184863631 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

Licenses✔ Licensed in GA · 003499✔ Licensed in CO · DR.0054622

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Also ListedInternal Medicine · Addiction MedicineTaxonomy 207RA0401X · License DR.0054622 (CO)

8181 E TUFTS AVE STE 560, Denver, CO 80237

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Secondary Practice Locations 3

Location 15175 E Main StColumbus, OH 43213-2425 · Phone (614) 575-1200

Location 21850 Race StDenver, CO 80206 · Phone (720) 725-1564

Location 38289 E Lowry BlvdDenver, CO 80230-7256 · Phone (303) 321-2828

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, UnitedHealthcare.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. Pradeep Rai 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 ID1850510124

PECOS Enrollment IDI20140918001274, I20150504000473, I20231025001079

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 20

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 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 moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

244 services132 patients

Removal of fingernails or toenails, 6 or more nails 11721

This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.

152 services98 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

82 services55 patients

Removal of muscle and/or tissue, each additional 20.0 sq cm or less 11046

This procedure involves the removal of muscle and/or tissue, typically to treat disease or injury. An additional 20.0 square cm or less of tissue may be removed if necessary. The process is performed by a skilled medical professional to ensure your safety and recovery.

74 services11 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.

62 services30 patients

Removal of fingernails or toenails, 1-5 nails 11720

This procedure involves the careful removal of 1-5 nails from fingers or toes. It's typically done to treat conditions like ingrown nails, fungal infections, or damaged nails. Local anesthesia is used for comfort, and the area heals over time with appropriate care.

60 services39 patients

Removal of muscle and/or tissue, 20.0 sq cm or less 11043

This procedure involves the surgical removal of a specified area (20.0 sq cm or less) of muscle and/or tissue. It's typically done to treat conditions like tumors, infections, or injuries. Local or general anesthesia ensures comfort. Recovery time varies.

58 services24 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

53 services53 patients

Trimming of dystrophic nails, any number G0127

Trimming of dystrophic nails involves the careful cutting and shaping of thickened or deformed nails. This is often required when nails are affected by conditions such as fungus or psoriasis. The procedure helps to reduce discomfort and improve nail health.

53 services35 patients

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.

51 services40 patients

Removal of fingernails or toenails, 6 or more nails 11721

39 services28 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

37 services37 patients

Ultrasound study of arm and leg arteries 93922

An ultrasound study of arm and leg arteries is a non-invasive procedure that uses sound waves to create images of your arteries. It helps in checking blood flow, identifying blockages, or detecting other abnormalities in your arteries.

34 services34 patients

Removal of skin and tissue, 20.0 sq cm or less 11042

This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.

32 services25 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.

22 services22 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.

21 services21 patients

Removal of skin and tissue, 20.0 sq cm or less 11042

20 services13 patients

Ultrasound study of arm and leg arteries 93922

17 services17 patients

Removal of fingernails or toenails, 1-5 nails 11720

14 services12 patients

Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99304

An initial nursing facility visit is a daily check-up to monitor your health status. This service, lasting typically 25 minutes, involves a nurse assessing your overall wellbeing, discussing concerns, and updating your care plan as needed.

14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80237 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

$89.43 typical visit price

range $58.06 – $174.82

Typical copayment $22.35 (range $14.51 – $43.70)

Most-billed visit code 99203

Established Patient

$72.20 typical visit price

range $18.88 – $142.79

Typical copayment $18.05 (range $4.72 – $35.69)

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.

72.27/100

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

Scored as part of a group practice

Quality

53.2

Promoting Interoperability

100

Improvement Activities

Cost

21.04

Reported Quality Measures

Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy - Neurological Evaluation

Percentage of patients aged 18 years and older with a diagnosis of diabetes mellitus who had a neurological examination of their lower extremities within 12 months

34%238 patients2/55-star benchmark: 100%

Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention - Evaluation of Footwear

Percentage of patients aged 18 years and older with a diagnosis of diabetes mellitus who were evaluated for proper footwear and sizing

22%246 patients1/55-star benchmark: 100%

Falls: Plan of Care

Percentage of patients aged 65 years and older with a history of falls that had a plan of care for falls documented within 12 months

100%66 patients5/55-star benchmark: 100%

Falls: Risk Assessment

Percentage of patients aged 65 years and older with a history of falls that had a risk assessment for falls completed within 12 months

100%65 patients5/55-star benchmark: 100%

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.

89%606 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.

Referred Medical Equipment & Supplies CMS DME claims 6

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

1 supplier13 claims17 services$9.40 avg. paid by Medicare

Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing A6196

DME-Medical/Surgical Supplies · category DA023N

1 supplier16 claims395 services$6.92 avg. paid by Medicare

Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6203

DME-Medical/Surgical Supplies · category DA023N

1 supplier19 claims358 services$2.83 avg. paid by Medicare

Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6222

DME-Medical/Surgical Supplies · category DA023N

1 supplier13 claims246 services$2.06 avg. paid by Medicare

Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing A6252

DME-Medical/Surgical Supplies · category DA023N

1 supplier11 claims232 services$2.93 avg. paid by Medicare

Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard A6446

DME-Medical/Surgical Supplies · category DA023N

1 supplier13 claims1,380 services$0.37 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 5

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

ASHLEY CHEN D.O.

Family Medicine