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DR. ANITA VARGHESE M.D.
NPI 1194152710
Internal Medicine - Infectious Disease in West Reading, PA

Active since September 27, 2013PECOS EnrolledAccepts Medicare Assignment
86.13/100
CMS Quality Rating
301 S 7TH AVE STE 120, WEST READING, PA 19611(484) 628-4630 Get Directions Write a Review

NPPES record last updated: February 9, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Anita Varghese M.d. NPPES

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

DR. ANITA VARGHESE M.D. (NPI 1194152710) is an individual infectious disease provider in West Reading, Pennsylvania, licensed in Pennsylvania (MD476259) and active in the NPI registry since September 2013. She is enrolled in Medicare PECOS, is affiliated with Reading Hospital, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1194152710
Entity TypeIndividualFemale
Primary Taxonomy207RI0200X
Provider Legal NameDR. ANITA VARGHESECredential: M.D.
Location Address301 S 7TH AVE STE 120West Reading, PA 19611-1449
Mailing Address107 New York AveReading, PA 19608-9684 · (516) 318-0099
Phone(484) 628-4630
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateSeptember 27, 2013
Last NPPES UpdateFebruary 9, 2022
NPPES CertifiedFebruary 9, 2022
✔ NPI 1194152710 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
Licenses✔ Licensed in PA · MD476259✔ Licensed in NJ · 25MA11150800✔ Licensed in NY · 270802
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
Also ListedInternal MedicineTaxonomy 207R00000X · License 25MA11150800 (NJ), MD476259 (PA), 270802 (NY)
301 S 7TH AVE STE 120, West Reading, PA 19611
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Other Names 1

Former Name (1)Dr. Anita Jose

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. Anita Varghese M.d. 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 ID4183850365
PECOS Enrollment IDI20220120000801
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

3

Medicare enrollment records show Anita Varghese reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Tower Health Medical Group
Same address
Reproductive Endocrinology
301 S 7TH AVE, STE 245
West Reading, PA 19611
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 1,473 clinicians in this Medicare group
NPI 1366889065 (484) 628-7900
Reading Hospital
Same address
Internal Medicine
301 S 7TH AVE STE 340
West Reading, PA 19611
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 399 clinicians in this Medicare group
NPI 1003175043 (484) 628-8480
Frank Scafuri III D.O.P,c
98 mi
Internal Medicine
2177 VICTORY BLVD
Staten Island, NY 10314
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: Frank Scafuri Iii Do PC
  • 17 clinicians in this Medicare group
NPI 1891029575 (718) 370-3730

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 4

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.

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.
442 services255 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.
212 services202 patients
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.
50 services42 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
20 services20 patients

Hospital Affiliations CMS Care Compare

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

Reading Hospital

Acute Care Hospitals · West Reading, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390044
Location420 S 5th AvenueWest Reading, PA 19611 · Berks County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19611 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

86.13/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.91
Promoting Interoperability99
Improvement Activities40
Cost62.83

Reported Quality Measures

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.
99%5,350 patients4/55-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.
93%1,947 patients4/55-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.
100%1,658 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.
96%1,658 patients4/55-star benchmark: 99%
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…
54%3,765 patients3/55-star benchmark: 97%
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
Patients screenedForUse: 97% · 892 patients
Patients tobacco: 20% · 892 patients
6%752 patients1/55-star benchmark: 98%
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…
44%1,658 patients2/55-star benchmark: 100%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 3% · 676 patients
12%676 patients2/55-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 6

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

READING HOSPITAL
Internal Medicine (Infectious Disease)
301 S 7TH AVE STE 120
WEST READING, PA 19611
Berks County (484) 628-4630
CHINWE CHIBUNDO ANEKWE M.D.
Internal Medicine (Infectious Disease)
301 S 7TH AVE STE 120
WEST READING, PA 19611
Berks County (484) 628-4630
CHARLES J SCHNAUBELT MSN ACNP-BC
Nurse Practitioner (Acute Care)
301 S 7TH AVE STE 120
READING, PA 19611
Berks County (484) 628-4630
READING HOSPITAL
Internal Medicine (Rheumatology)
301 S 7TH AVE STE 120
WEST READING, PA 19611
Berks County (484) 659-9950
NOELLE MARIE HEILMAN CRNP
Nurse Practitioner
301 S 7TH AVE STE 120
WEST READING, PA 19611
Berks County (484) 628-4630
READING HOSPITAL
Internal Medicine (Infectious Disease)
301 S 7TH AVE STE 120
WEST READING, PA 19611
Berks County (484) 628-4630

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 Anita Varghese's NPI number?

The NPI number for Anita Varghese is 1194152710. It was assigned to this individual provider in the NPPES registry on September 27, 2013. The provider is also known as Dr. Anita Jose.

Where is Anita Varghese located?

Anita Varghese practices at 301 S 7th Ave Ste 120, West Reading, PA 19611. The listed phone number is (484) 628-4630.

What is Anita Varghese's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Anita Varghese enrolled in Medicare?

Yes. Anita Varghese is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Anita Varghese's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Anita Varghese reassigns Medicare benefits to 3 organizations: Tower Health Medical Group (West Reading, PA), Reading Hospital (West Reading, PA) and Frank Scafuri III D.O.P,c (Staten Island, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Anita Varghese's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Anita Varghese affiliated with any hospitals?

According to CMS data, Anita Varghese is affiliated with Reading Hospital.

When was this NPI record last updated?

The NPPES record for Anita Varghese was last updated on February 9, 2022. 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.