MRS. NISHA ROY VARGHESE M.D.
NPI 1427137223
Internal Medicine - Endocrinology, Diabetes & Metabolism in Louisville, KY

Q: What is Nisha Varghese's NPI number?

The NPI number for Nisha Varghese is 1427137223. It was assigned to this individual provider in the NPPES registry on November 3, 2006.

Q: What is Nisha Varghese's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Q: When was this NPI record last updated?

The NPPES record for Nisha Varghese was last updated on June 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 November 03, 2006PECOS EnrolledAccepts Medicare Assignment

60.16/100

CMS Quality Rating

401 E CHESTNUT ST UNIT 710, LOUISVILLE, KY 40202(502) 583-8303 Get Directions Write a Review

NPPES record last updated: June 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mrs. Nisha Roy Varghese M.d. NPPES

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

MRS. NISHA ROY VARGHESE M.D. (NPI 1427137223) is an individual endocrinology, diabetes & metabolism provider in Louisville, Kentucky, licensed in Kentucky (37290) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS, is affiliated with Uofl Health - Shelbyville Hospital, and is a graduate of Other (1995).

NPPES Registry Identity

NPI1427137223

Entity TypeIndividualFemale

Primary Taxonomy207RE0101X

Provider Legal NameMRS. NISHA ROY VARGHESECredential: M.D.

Location Address401 E CHESTNUT ST UNIT 710Louisville, KY 40202-5707

Mailing AddressPo Box 909Louisville, KY 40201-0909

Phone(502) 583-8303

Sole ProprietorYes

Medical School CMSOtherGraduated 1995

Enumeration DateNovember 3, 2006

Last NPPES UpdateJune 7, 2023

NPPES CertifiedJune 7, 2023

✔ NPI 1427137223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians

Taxonomy Code207RE0101X

License✔ Licensed in KY · 37290

Definition

An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

401 E CHESTNUT ST UNIT 710, Louisville, KY 40202

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Other Identifiers 1

Medicaid6406315900KY

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

Mrs. Nisha Roy Varghese 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 ID7214911379

PECOS Enrollment IDI20040616000287

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.

471 services248 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.

324 services135 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

280 services124 patients

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251

This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.

191 services69 patients

Ultrasound scan of head and neck soft tissue 76536

An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.

77 services76 patients

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212

This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.

25 services23 patients

Hospital Affiliations CMS Care Compare 5

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

Baptist Health Louisville

Acute Care Hospitals · Louisville, KY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180130

Location4000 Kresge WayLouisville, KY 40207 · Jefferson County

Emergency services Birthing friendly

Baptist Health Lagrange

Acute Care Hospitals · La Grange, KY

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180138

Location1025 New Moody LaneLa Grange, KY 40031 · Oldham County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40202 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

$122.77 typical visit price

range $52.76 – $162.27

Typical copayment $30.69 (range $13.19 – $40.56)

Most-billed visit code 99204

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.

60.16/100

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

Individually scored

Quality

98.05

Improvement Activities

Cost

69.81

Reported Quality Measures

Controlling High Blood Pressure

81%618 patients4/55-star benchmark: 91%

Diabetes: Eye Exam

81%392 patients4/55-star benchmark: 100%

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

Lower rates are better for this measure.

15%392 patients4/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

93%3,533 patients4/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

98%1,382 patients5/55-star benchmark: 98%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 99% · 1,150 patients

Patients screened: 100% · 1,150 patients

91%65 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 7

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

Supplies for maintenance of insulin infusion catheter, per week A4224

DME-Other DME · category DE017N

4 suppliers20 claims260 services$18.27 avg. paid by Medicare

Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225

DME-Other DME · category DE017N

3 suppliers15 claims450 services$2.36 avg. paid by Medicare

Supply allowance for adjunctive continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service A4238

DME-Medical/Surgical Supplies · category DA000N

3 suppliers21 claims21 services$173.91 avg. paid by Medicare

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

40 suppliers174 claims664 services$6.30 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

24 suppliers54 claims98 services$1.00 avg. paid by Medicare

External ambulatory infusion pump, insulin E0784

DME-Other DME · category DE017N

2 suppliers13 claims13 services$321.16 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.

AMANDA JONES MSN, APRN, FNP-C

Nurse Practitioner