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DR. ARJUN MADHAVAN MD
NPI 1265612949
Internal Medicine - Pulmonary Disease in New Brunswick, NJ

Active since November 09, 2007PECOS EnrolledAccepts Medicare Assignment
254 EASTON AVE, NEW BRUNSWICK, NJ 08901(732) 745-8600 Get Directions Write a Review

NPPES record last updated: May 7, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Arjun Madhavan Md NPPES

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

DR. ARJUN MADHAVAN MD (NPI 1265612949) is an individual pulmonary disease provider in New Brunswick, New Jersey, licensed in New York (258161) and active in the NPI registry since November 2007. He is enrolled in Medicare PECOS, is affiliated with Saint Peter's University Hospital, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1265612949
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameDR. ARJUN MADHAVANCredential: MD
Location Address254 EASTON AVENew Brunswick, NJ 08901-1766
Mailing Address254 Easton AveNew Brunswick, NJ 08901-1766 · (732) 745-8600
Phone(732) 745-8600
Sole ProprietorYes
Medical School CMSOtherGraduated 2001
Enumeration DateNovember 9, 2007
Last NPPES UpdateMay 7, 2014
✔ NPI 1265612949 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in NY · 258161
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 258161 (NY)
254 EASTON AVE, New Brunswick, NJ 08901
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.Insurance ›

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. Arjun Madhavan 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 ID1052505203
PECOS Enrollment IDI20110909002814
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

2

Medicare enrollment records show Arjun Madhavan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Saint Peter's University Hospital
Same address
General Acute Care Hospital
254 EASTON AVE
New Brunswick, NJ 08901
  • Reassigned Medicare billing, New Jersey enrollment
  • Medicare enrollment name: Saint Peters University Hospital
  • 325 clinicians in this Medicare group
NPI 1114924834 (732) 745-6651
Saint Peter's Healthcare System Physician Associates
0.1 mi
General Practice
254 EASTON AVE
New Brunswick, NJ 08901
  • Reassigned Medicare billing, New Jersey enrollment
  • 105 clinicians in this Medicare group
NPI 1548569361 (732) 745-6651

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 9

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.
193 services66 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.
124 services61 patients
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.
94 services48 patients
Test to measure expiratory airflow and volume changes before and after medication administration 94060
This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.
24 services24 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 services20 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
21 services21 patients

Hospital Affiliations CMS Care Compare

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

Saint Peter's University Hospital

Acute Care Hospitals · New Brunswick, NJ
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310070
Location254 Easton AveNew Brunswick, NJ 08901 · Middlesex County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08901 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
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
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.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
39%120 patients2/55-star benchmark: 85%
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.
98%815 patients4/55-star benchmark: 99%
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%62 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.
93%242 patients4/55-star benchmark: 97%
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…
69%244 patients3/55-star benchmark: 97%
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…
77%242 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
9%242 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
17%242 patients
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 7

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
1 supplier21 claims21 services$30.06 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
1 supplier19 claims19 services$64.63 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
1 supplier18 claims54 services$23.97 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
2 suppliers15 claims15 services$12.51 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
2 suppliers23 claims132 services$1.60 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers33 claims33 services$23.81 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.

DR. AMIE KAWASHIMA D.O.
Orthopaedic Surgery (Pediatric Orthopaedic Surgery)
254 EASTON AVE
NEW BRUNSWICK, NJ 08901
Middlesex County (732) 339-7566
CRAIG M AUMACK RPH, PHARMD
Pharmacist
254 EASTON AVE
NEW BRUNSWICK, NJ 08901
Middlesex County (732) 745-8600
JENNIFER WALDMANN M.D
Internal Medicine (Critical Care Medicine)
254 EASTON AVE
NEW BRUNSWICK, NJ 08901
Middlesex County (732) 996-6741
MRS. MICHELE BRUNO HORNER MS, CGC
Genetic Counselor, MS
254 EASTON AVE
NEW BRUNSWICK, NJ 08901
Middlesex County (732) 745-6659
ERNESTO BRETON MD
Student in an Organized Health Care Education/Training Program
254 EASTON AVE
NEW BRUNSWICK, NJ 08901
Middlesex County (732) 745-8600
DR. I. MARK HIATT MD
Pediatrics (Neonatal-Perinatal Medicine)
254 EASTON AVE
NEW BRUNSWICK, NJ 08901
Middlesex County (732) 745-8600
JANTI CHAABAN MD
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
254 EASTON AVE, PEDIATRIC NEUROLOGY
NEW BRUNSWICK, NJ 08901
Middlesex County (732) 745-8600
SHERENE TANASHA DUNKLEY APN-C
Nurse Practitioner (Acute Care)
254 EASTON AVE
NEW BRUNSWICK, NJ 08901
Middlesex County (732) 745-8600

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 Arjun Madhavan's NPI number?

The NPI number for Arjun Madhavan is 1265612949. It was assigned to this individual provider in the NPPES registry on November 9, 2007.

Where is Arjun Madhavan located?

Arjun Madhavan practices at 254 Easton Ave, New Brunswick, NJ 08901. The listed phone number is (732) 745-8600.

What is Arjun Madhavan's specialty?

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

Is Arjun Madhavan enrolled in Medicare?

Yes. Arjun Madhavan 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 Arjun Madhavan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Arjun Madhavan reassigns Medicare benefits to 2 organizations: Saint Peter's University Hospital (New Brunswick, NJ) and Saint Peter's Healthcare System Physician Associates (New Brunswick, NJ). 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 Arjun Madhavan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Arjun Madhavan accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Arjun Madhavan 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 Arjun Madhavan affiliated with any hospitals?

According to CMS data, Arjun Madhavan is affiliated with Saint Peter's University Hospital.

When was this NPI record last updated?

The NPPES record for Arjun Madhavan was last updated on May 7, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.