DR. RAJESH BALAGANI DO
NPI 1477754927
Internal Medicine - Sleep Medicine in Janesville, WI

Q: What is Rajesh Balagani's NPI number?

The NPI number for Rajesh Balagani is 1477754927. It was assigned to this individual provider in the NPPES registry on May 31, 2007.

Q: What is Rajesh Balagani's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Rajesh Balagani was last updated on August 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 31, 2007PECOS EnrolledAccepts Medicare Assignment

3200 E RACINE ST, JANESVILLE, WI 53546(608) 371-8000(608) 371-8941 Get Directions Write a Review

NPPES record last updated: August 13, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 13, 2024, May 12, 2022, May 17, 2016 (3 updates tracked since 2016).

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About Dr. Rajesh Balagani Do NPPES

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

DR. RAJESH BALAGANI DO (NPI 1477754927) is an individual sleep medicine provider in Janesville, Wisconsin, licensed in Wisconsin (57354) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Ssm Health St Mary's Hospital - Madison, and is a graduate of Midwestern University, Chicago College Of Osteopathic Med (2001).

NPPES Registry Identity

NPI1477754927

Entity TypeIndividualMale

Primary Taxonomy207RS0012X

Provider Legal NameDR. RAJESH BALAGANICredential: DO

Location Address3200 E RACINE STJanesville, WI 53546-2343

Mailing Address3200 E Racine StJanesville, WI 53546-2343 · (608) 371-8000 · Fax (608) 371-8941

Phone(608) 371-8000

Fax(608) 371-8941

Sole ProprietorNo

Medical School CMSMidwestern University, Chicago College Of Osteopathic MedGraduated 2001

Enumeration DateMay 31, 2007

Last NPPES UpdateAugust 13, 20243 updates tracked since enumeration

NPPES CertifiedAugust 13, 2024

✔ NPI 1477754927 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Sleep MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RS0012X

License✔ Licensed in WI · 57354

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 36110912 (IL)

Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License 036110912 (IL), 57354-21 (WI)

3200 E RACINE ST, Janesville, WI 53546

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Other Identifiers 4

OtherBALAGRAJWI · Mercycare Insurance

Medicaid0361109121IL

Other1477754927WI · Bcbswi

Medicaid1477754927WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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. Rajesh Balagani Do 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 ID244289395

PECOS Enrollment IDI20130814000837

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 10

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 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.

186 services176 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.

76 services75 patients

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

Albuterol is a medication used to treat breathing problems. It is administered as an inhalation solution through a device called DME (Durable Medical Equipment). The solution is FDA-approved and non-compounded. Each unit dose contains 1 mg of the medicine.

60 services19 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.

42 services42 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

31 services30 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

31 services30 patients

Hospital Affiliations CMS Care Compare 2

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

Ssm Health St Mary's Hospital - Madison

Acute Care Hospitals · Madison, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520083

Location700 South Park StMadison, WI 53715 · Dane County

Emergency services Birthing friendly

Ssm Health St Mary's Hospital - Janesville

Acute Care Hospitals · Janesville, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number520208

Location3400 East Racine StreetJanesville, WI 53546 · Rock County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53546 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

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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.

Referred Medical Equipment & Supplies CMS DME claims 28

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

16 suppliers288 claims289 services$35.56 avg. paid by Medicare

Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003

DME-Other DME · category DE000N

4 suppliers11 claims22 services$1.13 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

16 suppliers165 claims165 services$78.31 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

16 suppliers187 claims395 services$31.39 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

9 suppliers81 claims322 services$18.99 avg. paid by Medicare

Pillow for use on nasal cannula type interface, replacement only, pair A7033

DME-Other DME · category DE001N

9 suppliers78 claims366 services$13.27 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

12 suppliers158 claims158 services$55.90 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

19 suppliers246 claims246 services$18.74 avg. paid by Medicare

Chinstrap used with positive airway pressure device A7036

DME-Other DME · category DE001N

4 suppliers16 claims16 services$9.75 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

12 suppliers112 claims112 services$11.38 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

22 suppliers426 claims1,613 services$2.10 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

14 suppliers203 claims203 services$11.59 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

6 suppliers55 claims56 services$17.96 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

2 suppliers59 claims59 services$801.02 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470

DME-Other DME · category DE001N

4 suppliers53 claims53 services$105.25 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0471

DME-Other DME · category DE001N

2 suppliers26 claims28 services$258.30 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

5 suppliers305 claims308 services$13.89 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

6 suppliers65 claims65 services$6.54 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

11 suppliers421 claims422 services$35.65 avg. paid by Medicare

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

12 suppliers329 claims329 services$95.52 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

7 suppliers106 claims106 services$34.60 avg. paid by Medicare

Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms J7606

DME-Drugs Administered Through DME · category DG006N

13 suppliers61 claims3,660 services$6.93 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

10 suppliers49 claims11,675 services$0.03 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

10 suppliers37 claims2,490 services$0.09 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

12 suppliers54 claims3,600 services$0.81 avg. paid by Medicare

Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram J7677

DME-Drugs Administered Through DME · category DG006N

13 suppliers69 claims362,075 services$0.15 avg. paid by Medicare

Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738

DME-Oxygen and Supplies · category DC000N

3 suppliers95 claims95 services$32.98 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

22 suppliers144 claims144 services$24.35 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 20

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

BRITTANY M. AUSTIN PA-C

Physician Assistant (Medical)

3200 E RACINE ST
JANESVILLE, WI 53546

Rock County (608) 371-8000

BETHANY SQUIER

Registered Nurse (Diabetes Educator)

3200 E RACINE ST
JANESVILLE, WI 53546

Rock County (608) 371-8225

JOHN M ZIEGLER MD

Pediatrics

3200 E RACINE ST
JANESVILLE, WI 53546

Rock County (608) 371-8000

STEVEN L LYON MD

Otolaryngology

3200 E RACINE ST
JANESVILLE, WI 53546

Rock County (608) 371-8000

JOSEPH O HUGHES PA-C

Physician Assistant

3200 E RACINE ST
JANESVILLE, WI 53546

Rock County (608) 371-8000

MACY G BOLT PT

Physical Therapist

3200 E RACINE ST
JANESVILLE, WI 53546

Rock County (608) 371-8000

KELSEY E OLSON PT

Physical Therapist

3200 E RACINE ST
JANESVILLE, WI 53546

Rock County (608) 373-8790

MARCUS A SOJKA DPT

Physical Therapist

3200 E RACINE ST
JANESVILLE, WI 53546

Rock County (608) 371-8000

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 Rajesh Balagani's NPI number?

The NPI number for Rajesh Balagani is 1477754927. It was assigned to this individual provider in the NPPES registry on May 31, 2007.

Where is Rajesh Balagani located?

Rajesh Balagani practices at 3200 E Racine St, Janesville, WI 53546. The listed phone number is (608) 371-8000.

What is Rajesh Balagani's specialty?

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

Is Rajesh Balagani enrolled in Medicare?

Yes. Rajesh Balagani 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 Rajesh Balagani accept?

Health plans from Anthem Blue Cross and Blue Shield list Rajesh Balagani 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 Rajesh Balagani affiliated with any hospitals?

According to CMS data, Rajesh Balagani is affiliated with Ssm Health St Mary's Hospital - Madison and Ssm Health St Mary's Hospital - Janesville.

When was this NPI record last updated?

The NPPES record for Rajesh Balagani was last updated on August 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.