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DR. POOJA RANBIRCHAND SETHI M.D
NPI 1306104385
Internal Medicine in Memphis, TN

Active since April 27, 2012PECOS EnrolledAccepts Medicare Assignment
75.06/100
CMS Quality Rating
880 MADISON AVE, MEMPHIS, TN 38103(901) 545-6969(901) 545-9748 Get Directions Write a Review

NPPES record last updated: June 29, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Pooja Ranbirchand Sethi M.d NPPES

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

DR. POOJA RANBIRCHAND SETHI M.D (NPI 1306104385) is an individual internal medicine provider in Memphis, Tennessee, licensed in Tennessee (52736) and active in the NPI registry since April 2012. She is enrolled in Medicare PECOS, is affiliated with Regional One Health, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1306104385
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. POOJA RANBIRCHAND SETHICredential: M.D
Location Address880 MADISON AVEMemphis, TN 38103-3409
Mailing Address877 Jefferson Ave, Attention: Provider EnrollmentMemphis, TN 38103-2807 · (901) 545-7302
Phone(901) 545-6969
Fax(901) 545-9748
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateApril 27, 2012
Last NPPES UpdateJune 29, 2015
✔ NPI 1306104385 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in TN · 52736
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
880 MADISON AVE, Memphis, TN 38103
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter Health and more.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. Pooja Ranbirchand Sethi 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 ID4284870114
PECOS Enrollment IDI20150831001840
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 Reassignment

Medicare enrollment records show Pooja Sethi reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ut Regional One Physicians Inc
0.1 mi
Surgery
877 JEFFERSON AVE
Memphis, TN 38103
  • Reassigned Medicare billing, Tennessee enrollment
  • 421 clinicians in this Medicare group
NPI 1093130585 (901) 545-8336

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

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.
99 services86 patients

Hospital Affiliations CMS Care Compare

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

Regional One Health

Acute Care Hospitals · Memphis, TN
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number440152
Location877 Jefferson AvenueMemphis, TN 38103 · Shelby County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38103 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
$121.80 typical visit price
range $52.64 – $160.89
Typical copayment $30.45 (range $13.16 – $40.22)
Most-billed visit code 99204
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
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.

75.06/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality56.46
Improvement Activities40
Cost71.87

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.

MICHELLE L RUSH MSN, APRN, BC
Nurse Practitioner (Family)
880 MADISON AVE
MEMPHIS, TN 38103
Shelby County (901) 545-6969
HANNAH SMITH PHARM.D.
Pharmacist
880 MADISON AVE
MEMPHIS, TN 38103
Shelby County (901) 545-6256
DR. KARL WEBER MD
Internal Medicine (Cardiovascular Disease)
880 MADISON AVE
MEMPHIS, TN 38103
Shelby County (901) 545-6969
ADELA CASTRO GUTIERREZ MD
Internal Medicine (Rheumatology)
880 MADISON AVE
MEMPHIS, TN 38103
Shelby County (901) 545-7259
DR. MACY MARIA GARCIA PHARMD
Pharmacy (Specialty Pharmacy)
880 MADISON AVE
MEMPHIS, TN 38103
Shelby County (901) 545-7970
SYED HASAN RAZA M.D.
Internal Medicine (Rheumatology)
880 MADISON AVE
MEMPHIS, TN 38103
Shelby County (901) 545-6969
NADENE BARKER NURSE PRACTITIONER
Nurse Practitioner (Psychiatric/Mental Health)
880 MADISON AVE
MEMPHIS, TN 38103
Shelby County (901) 545-7446
KIRAN JOGLEKAR
Internal Medicine (Gastroenterology)
880 MADISON AVE
MEMPHIS, TN 38103
Shelby County (901) 545-6969

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 Pooja Sethi's NPI number?

The NPI number for Pooja Sethi is 1306104385. It was assigned to this individual provider in the NPPES registry on April 27, 2012.

Where is Pooja Sethi located?

Pooja Sethi practices at 880 Madison Ave, Memphis, TN 38103. The listed phone number is (901) 545-6969.

What is Pooja Sethi's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Pooja Sethi enrolled in Medicare?

Yes. Pooja Sethi 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 organization bills Medicare for Pooja Sethi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Pooja Sethi reassigns Medicare benefits to Ut Regional One Physicians Inc (Memphis, TN). The 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 Pooja Sethi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Pooja Sethi accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 2 other insurers list Pooja Sethi 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 Pooja Sethi affiliated with any hospitals?

According to CMS data, Pooja Sethi is affiliated with Regional One Health.

When was this NPI record last updated?

The NPPES record for Pooja Sethi was last updated on June 29, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.