DR. PRIYANKA A POPHALI MD
NPI 1245598101
Internal Medicine - Hematology & Oncology in Madison, WI

Active since April 30, 2012PECOS EnrolledAccepts Medicare Assignment
600 HIGHLAND AVE, MADISON, WI 53792(608) 265-1700 Get Directions Write a Review

NPPES record last updated: January 19, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 19, 2021, Aug 15, 2019, Jul 3, 2018 (3 updates tracked since 2018).

About Dr. Priyanka A Pophali Md NPPES

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

DR. PRIYANKA A POPHALI MD (NPI 1245598101) is an individual hematology & oncology provider in Madison, Wisconsin, licensed in Wisconsin (70768) and active in the NPI registry since April 2012. She is enrolled in Medicare PECOS, is affiliated with University Of Wi Hospitals & Clinics Authority, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1245598101
Entity TypeIndividualFemale
Primary Taxonomy207RH0003X
Provider Legal NameDR. PRIYANKA A POPHALICredential: MD
Location Address600 HIGHLAND AVEMadison, WI 53792-0001
Mailing Address7974 Uw Health CtMiddleton, WI 53562-5531
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateApril 30, 2012
Last NPPES UpdateJanuary 19, 20213 updates tracked since enumeration
NPPES CertifiedJanuary 19, 2021
NPI 1245598101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
Licenses Licensed in WI · 70768 Licensed in MN · 59216
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Also ListedInternal MedicineTaxonomy 207R00000X · License 57.020726 (OH)
Also ListedInternal Medicine · HematologyTaxonomy 207RH0000X · License 59216 (MN)
600 HIGHLAND AVE, Madison, WI 53792

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

Dr. Priyanka A Pophali 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 ID7618288390
PECOS Enrollment IDI20190703000468
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 8

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 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.
158 services42 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.
103 services54 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.
44 services39 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
32 services18 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
21 services13 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
21 services20 patients

Hospital Affiliations CMS Care Compare

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

University Of Wi Hospitals & Clinics Authority

Acute Care Hospitals · Madison, WI
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number520098
Location600 Highland AvenueMadison, WI 53792 · Dane County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53792 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
$163.24 typical visit price
range $53.90 – $163.24
Typical copayment $40.81 (range $13.47 – $40.81)
Most-billed visit code 99205
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

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.

Pharmacist
600 HIGHLAND AVE, COMPLIANCE MAIL CODE 2433
MADISON, WI 53792
Ophthalmology
600 HIGHLAND AVE
MADISON, WI 53792
Surgery
600 HIGHLAND AVE
MADISON, WI 53792
Internal Medicine (Infectious Disease)
600 HIGHLAND AVE
MADISON, WI 53792
Anesthesiology
600 HIGHLAND AVE
MADISON, WI 53792
Transplant Surgery
600 HIGHLAND AVE
MADISON, WI 53792
Anesthesiology
600 HIGHLAND AVE
MADISON, WI 53792
Radiology (Radiation Oncology)
600 HIGHLAND AVE
MADISON, WI 53792

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 Priyanka Pophali's NPI number?

The NPI number for Priyanka Pophali is 1245598101. It was assigned to this individual provider in the NPPES registry on April 30, 2012.

Where is Priyanka Pophali located?

Priyanka Pophali practices at 600 Highland Ave, Madison, WI 53792. The listed phone number is (608) 265-1700.

What is Priyanka Pophali's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Is Priyanka Pophali enrolled in Medicare?

Yes. Priyanka Pophali 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 Priyanka Pophali accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Group Health Cooperative-SCW, HealthPartners and Quartz and 1 other insurer list Priyanka Pophali 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 Priyanka Pophali affiliated with any hospitals?

According to CMS data, Priyanka Pophali is affiliated with University Of Wi Hospitals & Clinics Authority.

When was this NPI record last updated?

The NPPES record for Priyanka Pophali was last updated on January 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.