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SANJAY BHATIA M.D.
NPI 1306810973
Neurological Surgery in Madison, WI

Active since February 13, 2006PECOS EnrolledAccepts Medicare Assignment
94.1/100
CMS Quality Rating
7409 TIMBER LAKE TRL APT 104, MADISON, WI 53719(724) 814-2198 Get Directions Write a Review

NPPES record last updated: June 20, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 20, 2019, Jun 19, 2018 (2 updates tracked since 2018).

About Sanjay Bhatia M.d. NPPES

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

SANJAY BHATIA M.D. (NPI 1306810973) is an individual neurological surgery provider in Madison, Wisconsin, licensed in Wisconsin (69315) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with West Virginia University Hospitals, Inc, and is a graduate of Other (1987).

NPPES Registry Identity

NPI1306810973
Entity TypeIndividualMale
Primary Taxonomy207T00000X
Provider Legal NameSANJAY BHATIACredential: M.D.
Location Address7409 TIMBER LAKE TRL APT 104Madison, WI 53719-3351
Mailing Address7409 Timber Lake Trl Apt 104Madison, WI 53719-3351 · (724) 814-2198
Phone(724) 814-2198
Sole ProprietorNo
Medical School CMSOtherGraduated 1987
Enumeration DateFebruary 13, 2006
Last NPPES UpdateJune 20, 20192 updates tracked since enumeration
✔ NPI 1306810973 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNeurological SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207T00000X
Licenses✔ Licensed in WI · 69315✔ Licensed in WV · 24189
Definition
A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.
Also ListedAnesthesiologyTaxonomy 207L00000X · License MD420967 (PA)
7409 TIMBER LAKE TRL APT 104, Madison, WI 53719
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Other Identifiers 1

Medicaid3003715000WV

Accepted Insurance

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

Sanjay Bhatia 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 ID7911914155
PECOS Enrollment IDI20100922000038
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 6

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.
49 services38 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
37 services37 patients
Computer-assisted radiosurgery of simple growth of brain, first growth 61796
Computer-assisted radiosurgery is a non-invasive treatment for brain growths. High-energy radiation beams are precisely targeted at the growth, destroying abnormal cells. This method is often used for the first growth, reducing risks associated with traditional surgery.
15 services14 patients
Computer-assisted radiosurgery application of headframe 61800
Computer-assisted radiosurgery with a headframe is a non-invasive procedure that treats brain conditions. A headframe is attached to your head to keep it still during treatment. Using advanced computer technology, precise high-dose radiation beams target the affected area without harming healthy tissues.
15 services14 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
15 services15 patients
Computer-assisted spinal procedure 61783
A computer-assisted spinal procedure is a surgical technique that uses computer technology for improved precision. It involves creating a 3D image of your spine to guide the surgeon during the operation. This method enhances accuracy, reduces risk, and promotes quicker recovery.
13 services12 patients

Hospital Affiliations CMS Care Compare 2

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

West Virginia University Hospitals, Inc

Acute Care Hospitals · Morgantown, WV
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510001
Location1 Medical Center DriveMorgantown, WV 26506 · Monongalia County
Emergency services Birthing friendly

Wheeling Hospital, Inc

Acute Care Hospitals · Wheeling, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number510050
Location1 Medical ParkWheeling, WV 26003 · Ohio County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53719 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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.

94.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.46
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 4

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

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
2 suppliers68 claims68 services$39.39 avg. paid by Medicare
Transport chair, adult size, patient weight capacity up to and including 300 pounds E1038
DME-Other DME · category DE000N
1 supplier21 claims21 services$5.05 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
2 suppliers64 claims64 services$13.25 avg. paid by Medicare
Lightweight wheelchair K0003
DME-Wheelchairs · category DD000N
2 suppliers41 claims41 services$21.37 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Sanjay Bhatia's NPI number?

The NPI number for Sanjay Bhatia is 1306810973. It was assigned to this individual provider in the NPPES registry on February 13, 2006.

Where is Sanjay Bhatia located?

Sanjay Bhatia practices at 7409 Timber Lake Trl Apt 104, Madison, WI 53719. The listed phone number is (724) 814-2198.

What is Sanjay Bhatia's specialty?

The primary specialty registered for this NPI is Neurological Surgery with taxonomy code 207T00000X.

Is Sanjay Bhatia enrolled in Medicare?

Yes. Sanjay Bhatia 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 Sanjay Bhatia accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and Highmark Blue Cross Blue Shield West Virginia and 1 other insurer list Sanjay Bhatia 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 Sanjay Bhatia affiliated with any hospitals?

According to CMS data, Sanjay Bhatia is affiliated with West Virginia University Hospitals, Inc and Wheeling Hospital, Inc.

When was this NPI record last updated?

The NPPES record for Sanjay Bhatia was last updated on June 20, 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.