PRABHAT K SINHA DO
NPI 1235332172
Internal Medicine - Pulmonary Disease in Farmington Hills, MI

Active since June 07, 2007PECOS EnrolledAccepts Medicare Assignment
65.04/100
CMS Quality Rating
29275 W 10 MILE RD, FARMINGTON HILLS, MI 48336(248) 350-2722(248) 350-0154 Get Directions Write a Review

NPPES record last updated: December 24, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Prabhat K Sinha Do NPPES

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

PRABHAT K SINHA DO (NPI 1235332172) is an individual pulmonary disease provider in Farmington Hills, Michigan, licensed in Michigan (5101014717) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS, is affiliated with Ascension Providence Hospital, Southfield And Novi, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1235332172
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NamePRABHAT K SINHACredential: DO
Location Address29275 W 10 MILE RDFarmington Hills, MI 48336-2817
Mailing Address29275 W 10 Mile RdFarmington Hills, MI 48336-2817 · (248) 350-2722 · Fax (248) 350-0154
Fax(248) 350-0154
Sole ProprietorYes
Medical School CMSOtherGraduated 2000
Enumeration DateJune 7, 2007
Last NPPES UpdateDecember 24, 2013
NPI 1235332172 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
Licenses Licensed in MI · 5101014717 Licensed in OH · 34008295
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 34008295 (OH), 5101014717 (MI)
Also ListedInternal Medicine · Sleep MedicineTaxonomy 207RS0012X · License 34008295 (OH), 5101014717 (MI)
29275 W 10 MILE RD, Farmington Hills, MI 48336

Other Identifiers 3

Medicare PINSI4244391OH
Medicare PIN0F34972MI
Other0E00425MI · Blue Cross Of Michigan

Accepted 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

Prabhat K Sinha Do 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 ID1658305909
PECOS Enrollment IDI20050926000555
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 14

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.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
487 services192 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.
374 services208 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.
302 services147 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.
142 services129 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.
137 services99 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.
40 services38 patients

Hospital Affiliations CMS Care Compare

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

Ascension Providence Hospital, Southfield And Novi

Acute Care Hospitals · Southfield, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230019
Location16001 W Nine Mile RdSouthfield, MI 48075 · Oakland County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48336 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
$134.28 typical visit price
range $58.04 – $177.36
Typical copayment $33.57 (range $14.51 – $44.34)
Most-billed visit code 99204
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
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.

65.04/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality91.5
Improvement Activities0
Cost75.07

Referred Medical Equipment & Supplies CMS DME claims 25

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
14 suppliers101 claims101 services$30.54 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
5 suppliers22 claims44 services$1.20 avg. paid by Medicare
Filter, disposable, used with aerosol compressor or ultrasonic generator A7013
DME-Other DME · category DE000N
2 suppliers14 claims14 services$0.50 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
11 suppliers78 claims78 services$68.53 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
10 suppliers69 claims125 services$27.27 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
7 suppliers26 claims92 services$13.55 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 20

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

Internal Medicine (Critical Care Medicine)
29275 W 10 MILE RD
FARMINGTON HILLS, MI 48336
Internal Medicine (Pulmonary Disease)
29275 W 10 MILE RD
FARMINGTON HILLS, MI 48336
Internal Medicine (Critical Care Medicine)
29275 W 10 MILE RD
FARMINGTON HILLS, MI 48336
Internal Medicine (Pulmonary Disease)
29275 W 10 MILE RD
FARMINGTON HILLS, MI 48336
Nurse Practitioner (Family)
29275 W 10 MILE RD
FARMINGTON HILLS, MI 48336
Internal Medicine (Pulmonary Disease)
29275 W 10 MILE RD
FARMINGTON HILLS, MI 48336
Internal Medicine (Pulmonary Disease)
29275 W 10 MILE RD
FARMINGTON HILLS, MI 48336
Student in an Organized Health Care Education/Training Program
29275 W 10 MILE RD
FARMINGTON HILLS, MI 48336

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 Prabhat Sinha's NPI number?

The NPI number for Prabhat Sinha is 1235332172. It was assigned to this individual provider in the NPPES registry on June 7, 2007.

Where is Prabhat Sinha located?

Prabhat Sinha practices at 29275 W 10 Mile Rd, Farmington Hills, MI 48336. The listed phone number is (248) 350-2722.

What is Prabhat Sinha's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Prabhat Sinha enrolled in Medicare?

Yes. Prabhat Sinha 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.

What insurance does Prabhat Sinha accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community, Priority Health and UnitedHealthcare list Prabhat Sinha as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Prabhat Sinha affiliated with any hospitals?

According to CMS data, Prabhat Sinha is affiliated with Ascension Providence Hospital, Southfield And Novi.

When was this NPI record last updated?

The NPPES record for Prabhat Sinha was last updated on December 24, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.