HEMANTH K PAI MD
NPI 1316086309
Internal Medicine in Albuquerque, NM

Active since February 06, 2007PECOS EnrolledAccepts Medicare Assignment
97.58/100
CMS Quality Rating
601 DR MARTIN LUTHER KING JR AVE NE STE 110, ALBUQUERQUE, NM 87102(505) 727-8360(505) 727-8678 Get Directions Write a Review

NPPES record last updated: February 3, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Hemanth K Pai Md NPPES

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

HEMANTH K PAI MD (NPI 1316086309) is an individual internal medicine provider in Albuquerque, New Mexico, licensed in New Mexico (MD2007-0673) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS, is affiliated with Unm Hospital, and is a graduate of University Of New Mexico School Of Medicine (2002).

NPPES Registry Identity

NPI1316086309
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameHEMANTH K PAICredential: MD
Location Address601 DR MARTIN LUTHER KING JR AVE NE STE 110Albuquerque, NM 87102-3619
Mailing Address500 Walter St Ne Ste 110Albuquerque, NM 87102-2541 · (505) 727-8360 · Fax (505) 727-8678
Fax(505) 727-8678
Sole ProprietorNo
Medical School CMSUniversity Of New Mexico School Of MedicineGraduated 2002
Enumeration DateFebruary 6, 2007
Last NPPES UpdateFebruary 3, 2024
NPPES CertifiedFebruary 3, 2024
NPI 1316086309 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in NM · MD2007-0673
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.

Also ListedInternal Medicine · Endocrinology, Diabetes & MetabolismTaxonomy 207RE0101X · License MD2007-0673 (NM)
Also ListedHospitalistTaxonomy 208M00000X · License MD2007-0673 (NM)
601 DR MARTIN LUTHER KING JR AVE NE STE 110, Albuquerque, NM 87102

Other Identifiers 1

Medicaid58537741NM

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

Hemanth K Pai Md 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 ID7416039219
PECOS Enrollment IDI20080201000292
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 4

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital inpatient care per day, typically 70 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.
113 services110 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.
31 services31 patients
Initial hospital observation care per day, typically 70 minutes 99220
This service involves a healthcare professional closely monitoring your health condition during your hospital stay. It typically lasts for about 70 minutes each day. This helps in timely detection of any changes in your health, allowing for immediate response and treatment.
18 services18 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.
13 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Unm Hospital

Acute Care Hospitals · Albuquerque, NM
2/5 CMS rating
OwnershipGovernment - State
CMS Certification Number320001
Location2211 Lomas Boulevard NEAlbuquerque, NM 87106 · Bernalillo County
Emergency services Birthing friendly

Lovelace Medical Center

Acute Care Hospitals · Albuquerque, NM
3/5 CMS rating
OwnershipProprietary
CMS Certification Number320009
Location601 Dr Martin Luther King Jr Ave NEAlbuquerque, NM 87102 · Bernalillo County
Emergency services

Presbyterian Hospital

Acute Care Hospitals · Albuquerque, NM
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number320021
Location1100 Central Avenue SEAlbuquerque, NM 87106 · Bernalillo County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87102 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
$126.21 typical visit price
range $54.26 – $166.80
Typical copayment $31.55 (range $13.56 – $41.70)
Most-billed visit code 99204
Established Patient
$96.38 typical visit price
range $17.00 – $135.35
Typical copayment $24.09 (range $4.25 – $33.83)
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.

97.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Quality86.53
Promoting Interoperability100
Improvement Activities40

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1316086309, enumerated as an "individual" on February 06, 2007.

The provider is located at 601 DR MARTIN LUTHER KING JR AVE NE STE 110 ALBUQUERQUE, NM 87102 and the phone number is (505) 727-8360.

Internal Medicine with taxonomy code 207R00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.

Hemanth Pai is affiliated with: UNM HOSPITAL, LOVELACE MEDICAL CENTER and PRESBYTERIAN HOSPITAL.