DR. MAMOON A. RAZA M.D.
NPI 1326098013
Internal Medicine - Gastroenterology in Elkhart, IN

Q: What is Mamoon Raza's NPI number?

The NPI number for Mamoon Raza is 1326098013. It was assigned to this individual provider in the NPPES registry on May 11, 2006.

Q: What is Mamoon Raza's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Mamoon Raza was last updated on September 19, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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 May 11, 2006PECOS EnrolledAccepts Medicare Assignment

91.85/100

CMS Quality Rating

303 S NAPPANEE ST, ELKHART, IN 46514(574) 296-3341(574) 296-3223 Get Directions Write a Review

NPPES record last updated: September 19, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Mamoon A. Raza M.d. NPPES

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

DR. MAMOON A. RAZA M.D. (NPI 1326098013) is an individual gastroenterology provider in Elkhart, Indiana, licensed in Indiana (01061775A) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Lee Memorial Hospital, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1326098013

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameDR. MAMOON A. RAZACredential: M.D.

Location Address303 S NAPPANEE STElkhart, IN 46514-2066

Mailing AddressP.o. Box 2968Elkhart, IN 46515-2968 · (574) 296-3341 · Fax (574) 296-3223

Phone(574) 296-3341

Fax(574) 296-3223

Sole ProprietorNo

Medical School CMSOtherGraduated 1998

Enumeration DateMay 11, 2006

Last NPPES UpdateSeptember 19, 2007

✔ NPI 1326098013 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in IN · 01061775A

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

303 S NAPPANEE ST, Elkhart, IN 46514

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Other Identifiers 2

Medicare UPINI68773IN

Medicare PIN227950C3IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter from Superior HealthPlan 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. Mamoon A. Raza 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 ID6305858861

PECOS Enrollment IDI20060627000123, I20251022003005

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 14

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.

Routine electrocardiogram (ecg) using at least 12 leads with tracing 93005

An Electrocardiogram (ECG) is a simple, painless test that records the heart's electrical activity. Using 12 leads attached to your skin, it generates a tracing of your heart rhythm. It helps detect any heart problems by showing the timing and strength of electrical signals passing through each part of your heart.

229 services228 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

111 services109 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

93 services93 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

55 services55 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

52 services52 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.

45 services37 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.

42 services38 patients

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.

38 services34 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

24 services23 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

24 services24 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

23 services23 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

20 services17 patients

Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm 43249

This procedure involves using a flexible tube with a camera, called an endoscope, to gently expand narrowed areas in your esophagus, stomach, or upper small bowel. A small balloon is inflated, making it easier for food and liquid to pass through. It's safe and effective.

15 services15 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

14 services14 patients

Hospital Affiliations CMS Care Compare 4

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

Lee Memorial Hospital

Acute Care Hospitals · Fort Myers, FL

5/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100012

Location2776 Cleveland AveFort Myers, FL 33901 · Lee County

Emergency services Birthing friendly

Gulf Coast Medical Center Lee Health

Acute Care Hospitals · Fort Myers, FL

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100220

Location13681 Doctors WayFort Myers, FL 33912 · Lee County

Emergency services

Cape Coral Hospital

Acute Care Hospitals · Cape Coral, FL

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100244

Location636 Del Prado BlvdCape Coral, FL 33990 · Lee County

Emergency services Birthing friendly

Elkhart General Hospital

Acute Care Hospitals · Elkhart, IN

4/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number150018

Location600 E BlvdElkhart, IN 46514 · Elkhart County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46514 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

$122.49 typical visit price

range $53.07 – $161.76

Typical copayment $30.62 (range $13.26 – $40.44)

Most-billed visit code 99204

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

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.

91.85/100

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

Individually scored

Quality

81.24

Promoting Interoperability

100

Improvement Activities

Cost

91.59

Reported Quality Measures

Breast Cancer Screening

58%114 patients3/55-star benchmark: 93%

Colorectal Cancer Screening

78%237 patients4/55-star benchmark: 88%

Controlling High Blood Pressure

86%113 patients4/55-star benchmark: 91%

Diabetes: Eye Exam

53%43 patients3/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

21%43 patients4/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

98%518 patients4/55-star benchmark: 100%

e-Prescribing

99%821 patients4/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

97%107 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

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

Iv pole E0776

DME-Other DME · category DE000N

1 supplier11 claims11 services$8.98 avg. paid by Medicare

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

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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.

MR. GORDON M HUGHES MD

Internal Medicine (Rheumatology)