MAYA P RAGHUWANSHI MD, MPH
NPI 1235216557
Internal Medicine - Endocrinology, Diabetes & Metabolism in Newark, NJ

NPI Status: Active since November 01, 2006

Contact Information

90 BERGEN ST
DOC 4500
NEWARK, NJ
ZIP 07103
Phone: (973) 972-2500
Fax: (973) 972-2510

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  • Individual
  • Female
  • Internal Medicine
  • Endocrinology, Diabetes & Metabolism
  • PECOS Enrolled

About MAYA RAGHUWANSHI

This page provides the complete NPI Profile along with additional information for Maya Raghuwanshi, an internist established in Newark, New Jersey with a medical specialization in Internal Medicine, focusing in endocrinology, diabetes & metabolism . The healthcare provider is registered in the NPI registry with number 1235216557 assigned on November 2006. The practitioner's primary taxonomy code is 207RE0101X with license number 25MA04198200 (NJ). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI
1235216557
Provider Name
MAYA P RAGHUWANSHI MD, MPH
Gender
Female
Entity Type
Individual
Location Address
90 BERGEN ST DOC 4500 NEWARK, NJ 07103
Location Phone
(973) 972-2500
Location Fax
(973) 972-2510
Mailing Address
30 BERGEN ST ADMC 12 1205 NEWARK, NJ 07107
Is Sole Proprietor?
No
Enumeration Date
11-01-2006
Last Update Date
01-25-2022
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An internist like Maya Raghuwanshi 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 Endocrinology, Diabetes & Metabolism

Taxonomy Code
207RE0101X
Type
Allopathic & Osteopathic Physicians
License No.
25MA04198200
License State
NJ
Taxonomy Description
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

Insurance Plans Accepted

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

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

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
3760103MEDICAID (05)NJ 

Medicare Participation & PECOS Enrollment Status

Maya Raghuwanshi 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

  • 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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE017N)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    18 DME suppliers used 53 Medicare Claims 116 Services Paid

  • DME-Medical/Surgical Supplies (DA000N)

    Lancets, per box of 100 (HCPCS:A4259)

    10 DME suppliers used 25 Medicare Claims 28 Services Paid

  • DME-Other DME (DE017N)

    Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)

    3 DME suppliers used 27 Medicare Claims 27 Services Paid

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.

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 97 times for 70 patients

Initial hospital inpatient care per day, typically 50 minutes

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.

This service was performed 15 times for 12 patients

Online digital evaluation and management service for an established patient for up to 7 days, total time 21 or more minutes

This service involves a week-long digital assessment and management program for existing patients. It includes continuous health monitoring, virtual consultations, and personalized treatment plans. The total time spent is 21 minutes or more, ensuring comprehensive care.

This service was performed 26 times for 20 patients

Physician Visit Costs

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 07103 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $144.86
  • Minimum New Patient Price $63.84
  • Maximum New Patient Price $190.92
  • Average New Patient Copayment $36.21
  • Minimum New Patient Copayment $15.96
  • Maximum New Patient Copayment $47.73

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $111.57
  • Minimum Established Patient Price $20.97
  • Maximum Established Patient Price $155.92
  • Average Established Patient Copayment $27.89
  • Minimum Established Patient Copayment $5.24
  • Maximum Established Patient Copayment $38.98

* 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.

Reviews for MAYA P RAGHUWANSHI MD, MPH

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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 1235216557, we treat the final digit (7) 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 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

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
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
3
Doubled → 6
Pos 4
5
Unchanged
Pos 5
2
Doubled → 4
Pos 6
1
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
5
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
7
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 3 → 6 2 → 4 6 → 12 → 3 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

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

2 + 2 + 6 + 5 + 4 + 1 + 1 + 2 + 5 + 1 + 0 + 24 = 53

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

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1235216557.

Other Providers at the Same Location


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

Genetic Counselor, MS
90 BERGEN ST, SUITE 5400
NEWARK, NJ 07103
Surgery (Plastic and Reconstructive Surgery)
90 BERGEN ST, DOC 7200
NEWARK, NJ 07103
Dentist (General Practice)
90 BERGEN ST, ST 7700
NEWARK, NJ 07103
Dentist (Prosthodontics)
90 BERGEN ST
NEWARK, NJ 07103
Neurological Surgery
90 BERGEN ST, DOC 8100
NEWARK, NJ 07103
Urology
90 BERGEN ST, DOC 2300
NEWARK, NJ 07103
Ophthalmology
90 BERGEN ST, DOC 6100
NEWARK, NJ 07103
Colon & Rectal Surgery
90 BERGEN ST, DOC 7100
NEWARK, NJ 07103
Physical Medicine & Rehabilitation
90 BERGEN ST, DOC 3100
NEWARK, NJ 07103
Internal Medicine (Geriatric Medicine)
90 BERGEN ST, DOC 4400
NEWARK, NJ 07103
Surgery
90 BERGEN ST, DOC 7100
NEWARK, NJ 07103
Transplant Surgery
90 BERGEN ST, DOC 7100
NEWARK, NJ 07103
Physical Medicine & Rehabilitation (Pain Medicine)
90 BERGEN ST, DOC 3100
NEWARK, NJ 07103
Psychiatry & Neurology (Neurology)
90 BERGEN ST, DOC 8100
NEWARK, NJ 07103
Surgery (Surgical Oncology)
90 BERGEN ST, DOC 7100
NEWARK, NJ 07103
Podiatrist (Foot & Ankle Surgery)
90 BERGEN ST, DOC 4500
NEWARK, NJ 07103
Radiology (Diagnostic Radiology)
90 BERGEN ST, DOC 1700 & 1500
NEWARK, NJ 07103
Psychiatry & Neurology (Neurology)
90 BERGEN ST, DOC 8100
NEWARK, NJ 07103
Emergency Medicine
90 BERGEN ST, ER DEPARTMENT
NEWARK, NJ 07103
Pharmacy (Community/Retail Pharmacy)
90 BERGEN ST, SUITE 1600
NEWARK, NJ 07103

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1235216557, enumerated as an "individual" on November 01, 2006.

The provider is located at 90 BERGEN ST DOC 4500 NEWARK, NJ 07103 and the phone number is (973) 972-2500.

Internal Medicine with taxonomy code 207RE0101X and a focus in Endocrinology, Diabetes & Metabolism.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.