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DR. HAMMAD RAZA M.D.
NPI 1265694475
Hospitalist in Paoli, PA

Active since June 29, 2008PECOS EnrolledAccepts Medicare Assignment
255 W LANCASTER AVE, PAOLI, PA 19301(484) 565-1510(484) 565-1513 Get Directions Write a Review

NPPES record last updated: June 9, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Hammad Raza M.d. NPPES

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

DR. HAMMAD RAZA M.D. (NPI 1265694475) is an individual hospitalist provider in Paoli, Pennsylvania, licensed in Pennsylvania (MD440322) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS, is affiliated with Upmc Carlisle, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1265694475
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameDR. HAMMAD RAZACredential: M.D.
Location Address255 W LANCASTER AVEPaoli, PA 19301-1763
Mailing Address255 W Lancaster AvePaoli, PA 19301-1763 · (484) 565-1510 · Fax (484) 565-1513
Phone(484) 565-1510
Fax(484) 565-1513
Sole ProprietorNo
Medical School CMSOtherGraduated 1998
Enumeration DateJune 29, 2008
Last NPPES UpdateJune 9, 2017
✔ NPI 1265694475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in PA · MD440322
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License MD440322 (PA)
255 W LANCASTER AVE, Paoli, PA 19301
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Highmark Blue Cross Blue Shield Delaware.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. Hammad Raza 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 ID4082739057
PECOS Enrollment IDI20100914000757
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 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 nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
1,919 services58 patients
Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310
A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
1,583 services59 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
224 services21 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.
215 services208 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
94 services44 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.
85 services30 patients

Hospital Affiliations CMS Care Compare 3

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

Upmc Carlisle

Acute Care Hospitals · Carlisle, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390058
Location361 Alexander Spring RoadCarlisle, PA 17015 · Cumberland County
Emergency services Birthing friendly

Upmc Pinnacle Hospitals

Acute Care Hospitals · Harrisburg, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390067
Location409 South Second StreetHarrisburg, PA 17104 · Dauphin County
Emergency services Birthing friendly

Riddle Memorial Hospital

Acute Care Hospitals · Media, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390222
Location1068 West Baltimore PikeMedia, PA 19063 · Delaware County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19301 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
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
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.

Referred Medical Equipment & Supplies CMS DME claims 11

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

Tracheostomy, inner cannula A4623
DME-Orthotic Devices · category DF000N
1 supplier61 claims1,830 services$6.23 avg. paid by Medicare
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each A7521
DME-Orthotic Devices · category DF000N
1 supplier19 claims19 services$45.25 avg. paid by Medicare
Tracheostomy tube collar/holder, each A7526
DME-Orthotic Devices · category DF000N
1 supplier65 claims520 services$3.28 avg. paid by Medicare
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
1 supplier137 claims1,918 services$4.19 avg. paid by Medicare
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152
Other-Enteral and Parenteral · category OB006N
1 supplier70 claims18,250 services$0.26 avg. paid by Medicare
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4154
Other-Enteral and Parenteral · category OB006N
1 supplier42 claims12,644 services$0.53 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.

TALIA LAGRAVINESE CRNP
Nurse Practitioner (Acute Care)
255 W LANCASTER AVE
PAOLI, PA 19301
Chester County (484) 565-1510
EMILY JANE DAMICO
Physician Assistant
255 W LANCASTER AVE
PAOLI, PA 19301
Chester County (215) 429-1003
MRS. LYNN B WOLFF CRNP
Nurse Practitioner (Acute Care)
255 W LANCASTER AVE
PAOLI, PA 19301
Chester County (484) 565-1600
MARY ANITA DILLOWAY MD
Pediatrics
255 W LANCASTER AVE, MOB 1 STE 101
PAOLI, PA 19301
Chester County (610) 644-9380
DR. SCOTT A. OLEX D.O.
Hospitalist
255 W LANCASTER AVE
PAOLI, PA 19301
Chester County (484) 565-1510
DR. JANIS ZVARGULIS M.D.
Anesthesiology
255 W LANCASTER AVE
PAOLI, PA 19301
Chester County (484) 565-1020
PAOLI PEDIATRICS PC
Pediatrics
255 W LANCASTER AVE, MOB 1 SUITE 101
PAOLI, PA 19301
Chester County (610) 644-9380
ADVOCARE, LLC
Hospitalist
255 W LANCASTER AVE
PAOLI, PA 19301
Chester County (610) 308-5755

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 Hammad Raza's NPI number?

The NPI number for Hammad Raza is 1265694475. It was assigned to this individual provider in the NPPES registry on June 29, 2008.

Where is Hammad Raza located?

Hammad Raza practices at 255 W Lancaster Ave, Paoli, PA 19301. The listed phone number is (484) 565-1510.

What is Hammad Raza's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Hammad Raza enrolled in Medicare?

Yes. Hammad Raza 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 Hammad Raza accept?

Health plans from Highmark Blue Cross Blue Shield Delaware list Hammad Raza 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 Hammad Raza affiliated with any hospitals?

According to CMS data, Hammad Raza is affiliated with Upmc Carlisle, Upmc Pinnacle Hospitals and Riddle Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Hammad Raza was last updated on June 9, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.