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DR. PRIYA VASSANT BORKER MD
NPI 1356753891
Internal Medicine - Sleep Medicine in Pittsburgh, PA

Active since June 02, 2014PECOS EnrolledAccepts Medicare Assignment
77.5/100
CMS Quality Rating
3459 FIFTH AVE, UPMC MONTEFIORE HOSPITAL, NW628, PITTSBURGH, PA 15213(667) 617-7000 Get Directions Write a Review

NPPES record last updated: July 14, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 14, 2021, Jul 3, 2018, Jun 29, 2018 (3 updates tracked since 2018).

About Dr. Priya Vassant Borker Md NPPES

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

DR. PRIYA VASSANT BORKER MD (NPI 1356753891) is an individual sleep medicine provider in Pittsburgh, Pennsylvania, licensed in Pennsylvania (MD474015) and active in the NPI registry since June 2014. She is enrolled in Medicare PECOS, is affiliated with Parma Community General Hospital, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1356753891
Entity TypeIndividualFemale
Primary Taxonomy207RS0012X
Provider Legal NameDR. PRIYA VASSANT BORKERCredential: MD
Location Address3459 FIFTH AVE, UPMC MONTEFIORE HOSPITAL, NW628Pittsburgh, PA 15213
Mailing Address3600 Forbes Avenue, Forbes Tower- Plaza Level Suite 140Pittsburgh, PA 15213 · (667) 617-7000
Phone(667) 617-7000
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateJune 2, 2014
Last NPPES UpdateJuly 14, 20213 updates tracked since enumeration
NPPES CertifiedJuly 14, 2021
✔ NPI 1356753891 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal Medicine · Sleep MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RS0012X
License✔ Licensed in PA · MD474015
Definition
An Internist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders.
Also ListedInternal MedicineTaxonomy 207R00000X · License MD474015 (PA)
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License MD474015 (PA)
Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License MD474015 (PA)
3459 FIFTH AVE, UPMC MONTEFIORE HOSPITAL, Pittsburgh, PA 15213
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Other Identifiers 1

Other260068MA · Limited License Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, 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. Priya Vassant Borker 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 ID4183931603
PECOS Enrollment IDI20240724003369
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 2

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.
71 services27 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.
13 services13 patients

Hospital Affiliations CMS Care Compare 5

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

Parma Community General Hospital

Acute Care Hospitals · Parma, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360041
Location7007 Powers BoulevardParma, OH 44129 · Cuyahoga County

University Hospitals Portage Medical Center

Acute Care Hospitals · Ravenna, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360078
Location6847 N ChestnutRavenna, OH 44266 · Portage County
Emergency services

Lake Health

Acute Care Hospitals · Concord, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360098
Location7590 Auburn RoadConcord, OH 44077 · Lake County
Emergency services

Uh Cleveland Medical Center

Acute Care Hospitals · Cleveland, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360137
Location11100 Euclid AvenueCleveland, OH 44106 · Cuyahoga County
Emergency services Birthing friendly

Uhhs Memorial Hospital Of Geneva

Critical Access Hospitals · Geneva, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number361307
Location870 West Main StreetGeneva, OH 44041 · Ashtabula County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15213 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

77.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality68.61
Promoting Interoperability100
Improvement Activities40
Cost56.4

Referred Medical Equipment & Supplies CMS DME claims 7

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
4 suppliers20 claims20 services$32.18 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
4 suppliers16 claims16 services$81.10 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
2 suppliers11 claims33 services$30.63 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
2 suppliers15 claims15 services$50.76 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
4 suppliers21 claims21 services$14.87 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
4 suppliers28 claims133 services$1.97 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Priya Borker's NPI number?

The NPI number for Priya Borker is 1356753891. It was assigned to this individual provider in the NPPES registry on June 2, 2014.

Where is Priya Borker located?

Priya Borker practices at 3459 Fifth Ave, Upmc Montefiore Hospital Nw628, Pittsburgh, PA 15213. The listed phone number is (667) 617-7000.

What is Priya Borker's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Sleep Medicine, with taxonomy code 207RS0012X.

Is Priya Borker enrolled in Medicare?

Yes. Priya Borker 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 Priya Borker accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Antidote Health Plan of Ohio, Inc. and CareSource and 2 other insurers list Priya Borker 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 Priya Borker affiliated with any hospitals?

According to CMS data, Priya Borker is affiliated with Parma Community General Hospital, University Hospitals Portage Medical Center, Lake Health, Uh Cleveland Medical Center and Uhhs Memorial Hospital Of Geneva.

When was this NPI record last updated?

The NPPES record for Priya Borker was last updated on July 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.