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NIRAJ GANJAWALA M.D.
NPI 1346772001
Family Medicine in Albuquerque, NM

Active since March 31, 2017PECOS EnrolledAccepts Medicare Assignment
83.84/100
CMS Quality Rating
MSC FAMILY MEDICINE, 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131(575) 517-0461 Get Directions Write a Review

NPPES record last updated: September 16, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 16, 2025, Jul 8, 2020, Mar 31, 2017 (3 updates tracked since 2017).

About Niraj Ganjawala M.d. NPPES

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

NIRAJ GANJAWALA M.D. (NPI 1346772001) is an individual family medicine provider in Albuquerque, New Mexico, licensed in Alabama (MD.41090) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS, is affiliated with Presbyterian Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1346772001
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameNIRAJ GANJAWALACredential: M.D.
Location AddressMSC FAMILY MEDICINE, 1 UNIVERSITY OF NEW MEXICOAlbuquerque, NM 87131-0001
Mailing Address1 University Of New MexicoAlbuquerque, NM 87131-0001 · (575) 517-0461
Phone(575) 517-0461
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateMarch 31, 2017
Last NPPES UpdateSeptember 16, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 16, 2025
✔ NPI 1346772001 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in AL · MD.41090
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedEmergency MedicineTaxonomy 207P00000X · License MD.41090 (AL), 73205 (AZ)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
MSC FAMILY MEDICINE, Albuquerque, NM 87131
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Secondary Practice Locations 2

Location 1380 Woods Cove RdScottsboro, AL 35768-2428 · Phone (256) 259-4444
Location 21912 Al Highway 157Cullman, AL 35058-0609 · Phone (256) 737-2000

Accepted Insurance

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

Niraj Ganjawala 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 ID1951672690
PECOS Enrollment IDI20210729001298, I20250403000097
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 5

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.

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.
150 services144 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
135 services132 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
103 services101 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
22 services22 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.
14 services13 patients

Hospital Affiliations CMS Care Compare 3

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

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

Carlsbad Medical Center

Acute Care Hospitals · Carlsbad, NM
1/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number320063
Location2430 West Pierce StreetCarlsbad, NM 88220 · Eddy County
Emergency services Birthing friendly

Cibola General Hospital

Critical Access Hospitals · Grants, NM
OwnershipVoluntary non-profit - Private
CMS Certification Number321308
Location1016 E Roosevelt AvenueGrants, NM 87020 · Cibola County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87131 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
$84.79 typical visit price
range $54.26 – $166.80
Typical copayment $21.19 (range $13.56 – $41.70)
Most-billed visit code 99203
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.

83.84/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality84.59
Promoting Interoperability100
Improvement Activities40
Cost58.63

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 Niraj Ganjawala's NPI number?

The NPI number for Niraj Ganjawala is 1346772001. It was assigned to this individual provider in the NPPES registry on March 31, 2017.

Where is Niraj Ganjawala located?

Niraj Ganjawala practices at Msc Family Medicine 1 University Of New Mexico, Albuquerque, NM 87131. The listed phone number is (575) 517-0461.

What is Niraj Ganjawala's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Niraj Ganjawala enrolled in Medicare?

Yes. Niraj Ganjawala 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 Niraj Ganjawala accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Superior HealthPlan and Ambetter of Oklahoma list Niraj Ganjawala 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 Niraj Ganjawala affiliated with any hospitals?

According to CMS data, Niraj Ganjawala is affiliated with Presbyterian Hospital, Carlsbad Medical Center and Cibola General Hospital.

When was this NPI record last updated?

The NPPES record for Niraj Ganjawala was last updated on September 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.