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RAJA SOHAIL ABBAS M.D.
NPI 1306057294
Psychiatry & Neurology - Psychiatry in Lehighton, PA

Active since May 24, 2007PECOS EnrolledAccepts Medicare Assignment
99/100
CMS Quality Rating
211 N 12TH ST, LEHIGHTON, PA 18235(610) 377-1300 Get Directions Write a Review

NPPES record last updated: February 28, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 28, 2019, Dec 13, 2016 (2 updates tracked since 2016).

About Raja Sohail Abbas M.d. NPPES

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

RAJA SOHAIL ABBAS M.D. (NPI 1306057294) is an individual psychiatry provider in Lehighton, Pennsylvania, licensed in Pennsylvania (MD433975) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with St Luke's Hospital Bethlehem, and is a graduate of Other (1999).

NPPES Registry Identity

NPI1306057294
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameRAJA SOHAIL ABBASCredential: M.D.
Location Address211 N 12TH STLehighton, PA 18235-1138
Mailing Address428 S 7th StLehighton, PA 18235-1824 · (106) 900-4234 · Fax (570) 392-6143
Phone(610) 377-1300
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateMay 24, 2007
Last NPPES UpdateFebruary 28, 20192 updates tracked since enumeration
✔ NPI 1306057294 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in PA · MD433975
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
211 N 12TH ST, Lehighton, PA 18235
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Other Identifiers 2

Medicaid1023379110001PA
Other160965HSUPA · Medicare Ptan

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware and more.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

Raja Sohail Abbas 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 ID3476607045
PECOS Enrollment IDI20090817000236
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.

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.
581 services124 patients
Psychotherapy, 1 hour 90837
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.
266 services83 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.
173 services57 patients
Psychotherapy, 45 minutes 90834
Psychotherapy is a treatment method where you converse with a therapist about your thoughts, feelings, and behaviors. In a 45-minute session, the therapist assists you in understanding and managing your mental health concerns, improving emotional wellness, and promoting personal growth.
57 services39 patients
Psychiatric diagnostic evaluation 90791
A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.
56 services56 patients
Psychotherapy with evaluation and management visit, 30 minutes 90833
Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.
53 services24 patients

Hospital Affiliations CMS Care Compare

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

St Luke's Hospital Bethlehem

Acute Care Hospitals · Bethlehem, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390049
Location801 Ostrum StreetBethlehem, PA 18015 · Northampton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18235 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
$166.87 typical visit price
range $54.64 – $166.87
Typical copayment $41.71 (range $13.66 – $41.71)
Most-billed visit code 99205
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
Most-billed visit code 99213
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.

99/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality85
Improvement Activities40
Cost100

Reported Quality Measures

Clinical Information Reconciliation
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation.
1%107 patients1/55-star benchmark: 100%
Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
90%199 patients4/55-star benchmark: 95%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
0%14,309 patients1/55-star benchmark: 100%
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.
99%11,136 patients4/55-star benchmark: 100%
Initiation and Engagement of Alcohol and Other Drug Dependence Treatment
Percentage of patients 13 years of age and older with a new episode of alcohol and other drug (AOD) dependence who received the following. Two rates are reported.
19%37 patients2/55-star benchmark: 59%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…
1%2,753 patients1/55-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…
9%2,485 patients1/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 30% · 2,178 patients
Patients tobacco: 20% · 2,178 patients
12%225 patients1/55-star benchmark: 98%
Provide Patient Access
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…
21%2,753 patients1/55-star benchmark: 100%
Request/Accept Summary of Care
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician receives or retrieves and incorporates into the patient's record an…
1%137 patients1/55-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 certified EHR technology to the patient (or the patient-authorized representative), or in…
1%2,753 patients1/55-star benchmark: 75%
Send a Summary of Care
For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider-(1) creates a summary of care record using certified EHR technology; and (2)…
1%137 patients1/55-star benchmark: 100%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 349 patients
14%349 patients2/55-star benchmark: 100%
View, Download and Transmit (VDT)
During the performance period, at least one unique patient (or patient-authorized representatives) seen by the MIPS eligible clinician actively engages with the EHR made accessible by the MIPS eligible clinician.
4%2,753 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.

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. HASAN BAYAT M.D.
Internal Medicine
211 N 12TH ST
LEHIGHTON, PA 18235
Carbon County (610) 377-7174
GNADEN HUETTEN MEMORIAL HOSPITAL
General Acute Care Hospital
211 N 12TH ST
LEHIGHTON, PA 18235
Carbon County (610) 377-1300
GNADEN HUETTEN MEMORIAL HOSPITAL
General Acute Care Hospital
211 N 12TH ST
LEHIGHTON, PA 18235
Carbon County (610) 377-1300
FRANK R PENATER MD
Family Medicine
211 N 12TH ST
LEHIGHTON, PA 18235
Carbon County (810) 377-7080
GNADEN HUETTEN MEMORIAL HOSPITAL
General Acute Care Hospital
211 N 12TH ST
LEHIGHTON, PA 18235
Carbon County (610) 377-1300
DR. JASON JOHN KISHEL DMD
Dentist
211 N 12TH ST, ATTENTION DENTAL DEPARTMENT
LEHIGHTON, PA 18235
Carbon County (610) 377-7354
HAMAYUN N AHMED M.D.
Psychiatry & Neurology (Psychiatry)
211 N 12TH ST
LEHIGHTON, PA 18235
Carbon County (610) 377-7174
GEORGE VIJAY JOSEPH
Psychiatry & Neurology (Psychiatry)
211 N 12TH ST
LEHIGHTON, PA 18235
Carbon County (610) 577-0555

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 Raja Abbas's NPI number?

The NPI number for Raja Abbas is 1306057294. It was assigned to this individual provider in the NPPES registry on May 24, 2007.

Where is Raja Abbas located?

Raja Abbas practices at 211 N 12th St, Lehighton, PA 18235. The listed phone number is (610) 377-1300.

What is Raja Abbas's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Raja Abbas enrolled in Medicare?

Yes. Raja Abbas 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 Raja Abbas accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Buckeye Health Plan and Providence Health Plan list Raja Abbas 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 Raja Abbas affiliated with any hospitals?

According to CMS data, Raja Abbas is affiliated with St Luke's Hospital Bethlehem.

When was this NPI record last updated?

The NPPES record for Raja Abbas was last updated on February 28, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.