NAGAMALAR RAJU M.D
NPI 1285894188
Internal Medicine - Sleep Medicine in Jasper, GA

Active since June 13, 2008PECOS EnrolledAccepts Medicare Assignment
98.5/100
CMS Quality Rating
1020 J L WHITE DR, SUITE 110A, JASPER, GA 30143(706) 299-2220(706) 253-2226 Get Directions Write a Review

NPPES record last updated: January 7, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Nagamalar Raju M.d NPPES

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

NAGAMALAR RAJU M.D (NPI 1285894188) is an individual sleep medicine provider in Jasper, Georgia, licensed in Georgia (065786) and active in the NPI registry since June 2008. She is enrolled in Medicare PECOS, is affiliated with Piedmont Hospital, and is a graduate of Temple University School Of Medicine (1998).

NPPES Registry Identity

NPI1285894188
Entity TypeIndividualFemale
Primary Taxonomy207RS0012X
Provider Legal NameNAGAMALAR RAJUCredential: M.D
Location Address1020 J L WHITE DR, SUITE 110AJasper, GA 30143-4908
Mailing Address1020 J L White Dr, Suite 110aJasper, GA 30143-4908 · (706) 299-2220 · Fax (706) 253-2226
Fax(706) 253-2226
Sole ProprietorNo
Medical School CMSTemple University School Of MedicineGraduated 1998
Enumeration DateJune 13, 2008
Last NPPES UpdateJanuary 7, 2016
NPI 1285894188 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Sleep MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RS0012X
License Licensed in GA · 065786
Definition
An Internist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders.
Also ListedInternal MedicineTaxonomy 207R00000X · License 065786 (GA)
1020 J L WHITE DR, Jasper, GA 30143

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

Nagamalar Raju 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 ID1355539982
PECOS Enrollment IDI20110726000882
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 11

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.

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.
364 services254 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
141 services141 patients
Sleep study including heart rate, breathing, airflow, and effort 95806
A sleep study monitors your heart rate, breathing patterns, airflow, and physical effort while you sleep. It helps identify sleep disorders by tracking your sleep stages and cycles. This data aids doctors in diagnosing and treating sleep-related issues.
87 services85 patients
Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811
A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.
61 services57 patients
Therapy procedure using a positive pressure ventilator 94660
A positive pressure ventilator is a device that helps with breathing. It pushes air into the lungs to assist in maintaining oxygen levels. This can be essential for patients with conditions that affect their ability to breathe independently. It's non-invasive and comfortable.
60 services56 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.
58 services38 patients

Hospital Affiliations CMS Care Compare 2

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

Piedmont Hospital

Acute Care Hospitals · Atlanta, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110083
Location1968 Peachtree Rd NWAtlanta, GA 30309 · Fulton County
Emergency services Birthing friendly

Piedmont Mountainside Hospital Inc

Acute Care Hospitals · Jasper, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110225
Location1266 Highway 515 SouthJasper, GA 30143 · Pickens County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30143 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

98.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability98
Improvement Activities40

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
76%493 patients3/55-star benchmark: 100%
Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation
Percentage of patients aged 18 years and older with a diagnosis of COPD who had spirometry results documented
27%26 patients2/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
73%338 patients3/55-star benchmark: 100%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
4%28 patients1/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
66%493 patients3/55-star benchmark: 100%
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…
99%534 patients4/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
63%169 patients3/55-star benchmark: 98%
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 19

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
25 suppliers757 claims757 services$38.73 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
26 suppliers582 claims582 services$94.43 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
24 suppliers573 claims1,548 services$36.13 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
20 suppliers315 claims1,731 services$20.32 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
25 suppliers255 claims1,420 services$14.87 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
30 suppliers572 claims572 services$57.96 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 5

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

Nurse Practitioner (Family)
1020 J L WHITE DR, SUITE 110A
JASPER, GA 30143
Nurse Practitioner (Family)
1020 J L WHITE DR, SUITE 170
JASPER, GA 30143
Family Medicine
1020 J L WHITE DR, SUITE 170
JASPER, GA 30143
Physician Assistant (Medical)
1020 J L WHITE DR, SUITE 160
JASPER, GA 30143
Family Medicine
1020 J L WHITE DR, SUITE 170
JASPER, GA 30143

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 Nagamalar Raju's NPI number?

The NPI number for Nagamalar Raju is 1285894188. It was assigned to this individual provider in the NPPES registry on June 13, 2008.

Where is Nagamalar Raju located?

Nagamalar Raju practices at 1020 J L White Dr Suite 110A, Jasper, GA 30143. The listed phone number is (706) 299-2220.

What is Nagamalar Raju's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Sleep Medicine, with taxonomy code 207RS0012X.

Is Nagamalar Raju enrolled in Medicare?

Yes. Nagamalar Raju 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 Nagamalar Raju accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Nagamalar Raju 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 Nagamalar Raju affiliated with any hospitals?

According to CMS data, Nagamalar Raju is affiliated with Piedmont Hospital and Piedmont Mountainside Hospital Inc.

When was this NPI record last updated?

The NPPES record for Nagamalar Raju was last updated on January 7, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.