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NISHA SINHA M.D.
NPI 1316383227
Psychiatry & Neurology - Neurology in Ocala, FL

Active since May 17, 2013PECOS EnrolledAccepts Medicare Assignment
88.47/100
CMS Quality Rating
1725 SE 28TH LOOP STE 101, OCALA, FL 34471(352) 629-1730 Get Directions Write a Review

NPPES record last updated: January 29, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 29, 2020, Oct 14, 2019, May 7, 2019 and 1 more (4 updates tracked since 2018).

About Nisha Sinha M.d. NPPES

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

NISHA SINHA M.D. (NPI 1316383227) is an individual neurology provider in Ocala, Florida, licensed in Florida (136531) and active in the NPI registry since May 2013. She is enrolled in Medicare PECOS, is affiliated with Hca Florida Citrus Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1316383227
Entity TypeIndividualFemale
Primary Taxonomy2084N0400X
Provider Legal NameNISHA SINHACredential: M.D.
Location Address1725 SE 28TH LOOP STE 101Ocala, FL 34471-5328
Mailing Address1725 Se 28th Loop Ste 101Ocala, FL 34471-5328 · (352) 629-1730 · Fax (352) 629-3520
Phone(352) 629-1730
Sole ProprietorYes
Medical School CMSOtherGraduated 2009
Enumeration DateMay 17, 2013
Last NPPES UpdateJanuary 29, 20204 updates tracked since enumeration
✔ NPI 1316383227 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
Licenses✔ Licensed in FL · 136531✔ Licensed in AZ · R73940
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Also ListedPsychiatry & Neurology · Clinical NeurophysiologyTaxonomy 2084N0600X · License 136531 (AZ)
1725 SE 28TH LOOP STE 101, Ocala, FL 34471
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11400 N US Highway 441 Ste 524The Villages, FL 32159-8984 · Phone (352) 751-8790
Location 24600 SW 46th CtOcala, FL 34474-5708 · Phone (352) 291-3000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama 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

Nisha Sinha 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 ID2466707062
PECOS Enrollment IDI20181114000831
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 10

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
751 services475 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.
621 services585 patients
Measurement of brain wave activity (eeg), awake and drowsy 95816
Measurement of brain wave activity, also known as an EEG, is a non-invasive test that records electrical patterns in your brain. This procedure is done when you're awake and drowsy to understand how your brain functions during different states of consciousness.
128 services121 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
97 services76 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
77 services76 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.
32 services30 patients

Hospital Affiliations CMS Care Compare 2

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

Hca Florida Citrus Hospital

Acute Care Hospitals · Inverness, FL
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100023
Location502 W Highland BlvdInverness, FL 34452 · Citrus County
Emergency services Birthing friendly

Marion Communtiy Hospital

Acute Care Hospitals · Ocala, FL
1/5 CMS rating
OwnershipProprietary
CMS Certification Number100212
Location1431 SW 1st AveOcala, FL 34471 · Marion County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34471 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

88.47/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality85.64
Promoting Interoperability100
Improvement Activities40
Cost63.96

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
1%89 patients1/55-star benchmark: 92%
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.
100%375 patients5/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
56%251 patients3/55-star benchmark: 99%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
14%251 patients1/55-star benchmark: 90%
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…
31%303 patients2/55-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 tobacco: 93% · 61 patients
95%61 patients
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+: 2% · 251 patients
3%251 patients4/55-star benchmark: 100%
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 2

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

DR. KARL ALBERT KASISCHKE M.D.
Psychiatry & Neurology (Neurology)
1725 SE 28TH LOOP STE 101
OCALA, FL 34471
Marion County (352) 629-1743
MEGHAN COON NP
Nurse Practitioner
1725 SE 28TH LOOP STE 101
OCALA, FL 34471
Marion County (352) 629-1743

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 Nisha Sinha's NPI number?

The NPI number for Nisha Sinha is 1316383227. It was assigned to this individual provider in the NPPES registry on May 17, 2013.

Where is Nisha Sinha located?

Nisha Sinha practices at 1725 SE 28th Loop Ste 101, Ocala, FL 34471. The listed phone number is (352) 629-1730.

What is Nisha Sinha's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Nisha Sinha enrolled in Medicare?

Yes. Nisha Sinha 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 Nisha Sinha accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, AvMed and Florida Blue (BlueCross BlueShield FL) and 3 other insurers list Nisha Sinha 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 Nisha Sinha affiliated with any hospitals?

According to CMS data, Nisha Sinha is affiliated with Hca Florida Citrus Hospital and Marion Communtiy Hospital.

When was this NPI record last updated?

The NPPES record for Nisha Sinha was last updated on January 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.