DR. VIJAY M RAGHAVAN MD
NPI 1316948995
Internal Medicine - Medical Oncology in Louisville, KY

Q: What is Vijay Raghavan's NPI number?

The NPI number for Vijay Raghavan is 1316948995. It was assigned to this individual provider in the NPPES registry on August 9, 2005.

Q: What is Vijay Raghavan's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Medical Oncology, with taxonomy code 207RX0202X.

Q: When was this NPI record last updated?

The NPPES record for Vijay Raghavan was last updated on October 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since August 09, 2005PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

1460 BLUEGRASS AVE, LOUISVILLE, KY 40215(502) 361-8496 Get Directions Write a Review

NPPES record last updated: October 13, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 13, 2021, Sep 28, 2021, May 23, 2020 and 2 more (5 updates tracked since 2017).

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About Dr. Vijay M Raghavan Md NPPES

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

DR. VIJAY M RAGHAVAN MD (NPI 1316948995) is an individual medical oncology provider in Louisville, Kentucky, licensed in Kentucky (33876) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Uofl Health - Shelbyville Hospital, and is a graduate of Other (1985).

NPPES Registry Identity

NPI1316948995

Entity TypeIndividualMale

Primary Taxonomy207RX0202X

Provider Legal NameDR. VIJAY M RAGHAVANCredential: MD

Location Address1460 BLUEGRASS AVELouisville, KY 40215-1272

Mailing AddressPo Box 909Louisville, KY 40201-0909 · (502) 361-8496

Phone(502) 361-8496

Sole ProprietorNo

Medical School CMSOtherGraduated 1985

Enumeration DateAugust 9, 2005

Last NPPES UpdateOctober 13, 20215 updates tracked since enumeration

NPPES CertifiedOctober 13, 2021

✔ NPI 1316948995 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Medical OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RX0202X

License✔ Licensed in KY · 33876

Definition

An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer.

Also ListedInternal Medicine · Hematology & OncologyTaxonomy 207RH0003X · License 01043397A (IN)

1460 BLUEGRASS AVE, Louisville, KY 40215

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Other Identifiers 2

Medicaid64338767KY

Medicaid6590070600KY

Accepted Insurance

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

Dr. Vijay M Raghavan 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 ID3072610492

PECOS Enrollment IDI20091117000063

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 7

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.

500 services184 patients

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.

210 services139 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

190 services80 patients

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.

78 services28 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

50 services50 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 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.

40 services38 patients

Hospital Affiliations CMS Care Compare 4

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

Uofl Health - Shelbyville Hospital

Acute Care Hospitals · Shelbyville, KY

OwnershipVoluntary non-profit - Private

CMS Certification Number180016

Location727 Hospital DriveShelbyville, KY 40065 · Shelby County

Emergency services

Jewish Hospital & St Mary's Healthcare

Acute Care Hospitals · Louisville, KY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180040

Location200 Abraham Flexner WayLouisville, KY 40202 · Jefferson County

Emergency services

Norton Hospitals, Inc

Acute Care Hospitals · Louisville, KY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180088

Location200 East Chestnut StreetLouisville, KY 40202 · Jefferson County

Emergency services Birthing friendly

University Of Louisville Hospital

Acute Care Hospitals · Louisville, KY

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180141

Location530 South Jackson StreetLouisville, KY 40202 · Jefferson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40215 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

$162.27 typical visit price

range $52.76 – $162.27

Typical copayment $40.56 (range $13.19 – $40.56)

Most-billed visit code 99205

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

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.

75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

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.

88%69 patients4/55-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.

81%570 patients3/55-star benchmark: 100%

Oncology: Medical and Radiation - Pain Intensity Quantified

Percentage of patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy in which pain intensity is quantified

98%731 patients4/55-star benchmark: 100%

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…

47%458 patients2/55-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…

29%822 patients2/55-star benchmark: 97%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

73%357 patients4/55-star benchmark: 88%

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…

30%458 patients2/55-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…

10%458 patients1/55-star benchmark: 77%

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% · 434 patients

5%434 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.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers13 claims13 services$57.81 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$29.28 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 11

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

JENNIFER NICOLE EASON MSN, APRN, FNP-C

Nurse Practitioner (Family)