RAGHAV SHARMA MD
NPI 1477872885
Internal Medicine - Interventional Cardiology in Winter Park, FL

NPI Status: Active since May 25, 2010

Contact Information

1035 N ORLANDO AVE STE 205
WINTER PARK, FL
ZIP 32789
Phone: (321) 274-8701
Fax: (321) 274-8702

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  • Individual
  • Male
  • Years of Experience 16
  • Internal Medicine
  • Interventional Cardiology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About RAGHAV SHARMA

This page provides the complete NPI Profile along with additional information for Raghav Sharma, an internist established in Winter Park, Florida with a medical specialization in Internal Medicine, focusing in interventional cardiology and more than 16 years of experience. The healthcare provider is registered in the NPI registry with number 1477872885 assigned on May 2010. The practitioner's primary taxonomy code is 207RI0011X with license number ME139953 (FL). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI
1477872885
Provider Name
RAGHAV SHARMA MD
Gender
Male
Entity Type
Individual
Location Address
1035 N ORLANDO AVE STE 205 WINTER PARK, FL 32789
Location Phone
(321) 274-8701
Location Fax
(321) 274-8702
Mailing Address
1035 N ORLANDO AVE STE 205 WINTER PARK, FL 32789
Mailing Phone
(321) 274-8701
Mailing Fax
(321) 274-8702
Medical School Name
OTHER
Graduation Year
2010
Is Sole Proprietor?
No
Enumeration Date
05-25-2010
Last Update Date
08-03-2023
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An internist like Raghav Sharma is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine Interventional Cardiology

Taxonomy Code
207RI0011X
Type
Allopathic & Osteopathic Physicians
License No.
ME139953
License State
FL
Taxonomy Description
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207R00000XAllopathic & Osteopathic Physicians

Internal Medicine

272390 (NY)
2208600000XAllopathic & Osteopathic Physicians

Surgery

MT197908 (PA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Complete VALUE Gold - HMO
  • Focused VALUE Silver - HMO
  • Focused VALUE Silver + Vision + Adult Dental - HMO
  • Standard Gold VALUE - HMO
  • Standard Silver VALUE - HMO
  • Standard Silver VALUE + Vision + Adult Dental - HMO
  • Clarity Silver - HMO
  • Clarity VALUE Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete VALUE Gold - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite VALUE Bronze - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
  • BlueOptions Bronze 24J01-04 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-06 (Rewards) - PPO
  • BlueOptions Bronze 24J01-17 ($50 PCP Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-18S ($50 PCP Visits / Rewards) - PPO
  • BlueOptions Gold 24J01-09 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - PPO
  • BlueOptions Gold 24J01-12 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - PPO
  • BlueOptions Gold 24J01-20S ($30 PCP Visits / $60 Specialist Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-05 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-08 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - PPO
  • BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
  • BlueCare Bronze 24K01-03 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K01-05 (Rewards) - POS
  • BlueCare Bronze 24K01-25 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K01-31S ($50 PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K02-17 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K02-18 (Rewards) - POS
  • BlueCare Bronze 24K02-23 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K02-26S ($50 PCP Visits / Rewards) - POS
  • BlueCare Gold 24K01-08 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
  • Molina Bronze Enhanced 3500 - HMO
  • Molina Bronze Enhanced 3500 Plus with Adult Dental and Vision - HMO
  • Molina Bronze Enhanced 3500 Plus with Adult Vision - HMO
  • Molina Bronze Premier with $0 Medical Deductible - HMO
  • Molina Bronze Premier with $0 Medical Deductible Plus with Adult Dental and Vision - HMO
  • Molina Bronze Premier with $0 Medical Deductible Plus with Adult Vision - HMO
  • Molina Bronze Standard - HMO
  • Molina Gold Core 1640 - HMO
  • Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
  • Molina Gold Core 1640 Plus with Adult Vision - HMO
  • Bronze Classic 4700 - HMO
  • Bronze Classic 4700 | with AdventHealth - HMO
  • Bronze Classic Standard - HMO
  • Bronze Classic Standard | with AdventHealth - HMO
  • Bronze Elite + PCP Saver Plus - HMO
  • Bronze Elite + PCP Saver Plus | with AdventHealth - HMO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
  • Bronze Simple Chronic Care CKM - HMO
  • Bronze Simple Diabetes - HMO
  • Gold Classic Standard - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
103621700MEDICAID (05)FL 
QH446OTHER (01)FLHF MA

Medicare Participation & PECOS Enrollment Status

Raghav Sharma is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Raghav Sharma is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 6406170117

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20190813003586

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: No

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Coronary angioplasty and stenting

Coronary angioplasty and stenting is a procedure to open narrowed or blocked heart arteries. A thin tube is inserted into a blood vessel, usually in the leg or arm, and guided to the heart. A small balloon at the end of the tube is inflated to widen the artery. A stent, a small wire mesh tube, may be placed in the artery to keep it open.

This service was performed for 1-10 patients

Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist

This procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.

This service was performed 27 times for 27 patients

Leg revascularization (restoring blood flow)

Leg revascularization is a procedure aimed at restoring proper blood flow to your legs. It's often needed when blood vessels in your legs are blocked or narrowed. The process may involve surgery or less invasive methods to remove or bypass blockages, helping to alleviate pain and prevent serious complications.

This service was performed for 1-10 patients

Pacemaker insertion or repair

Pacemaker insertion or repair is a procedure to help regulate your heartbeat. A small device, called a pacemaker, is implanted under the skin near your heart. This device sends electrical signals to prompt your heart to beat at a normal rate. In a repair procedure, the pacemaker may be adjusted, replaced, or the wires connecting it to your heart may be fixed.

This service was performed for 1-10 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $32.51 for a new patient copayment and $24.79 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 32789 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $130.04
  • Minimum New Patient Price $56
  • Maximum New Patient Price $171.84
  • Average New Patient Copayment $32.51
  • Minimum New Patient Copayment $14
  • Maximum New Patient Copayment $42.96

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $99.16
  • Minimum Established Patient Price $17.57
  • Maximum Established Patient Price $139.16
  • Average Established Patient Copayment $24.79
  • Minimum Established Patient Copayment $4.39
  • Maximum Established Patient Copayment $34.79

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Raghav Sharma is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
ADVENTHEALTH ORLANDO601 E ROLLINS ST
ORLANDO, FL 32803
(407) 303-1976Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1477872885, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 75. The final step is to find the difference between that total and the next multiple of ten (80 - 75 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
7
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
7
Unchanged
Pos 7
2
Doubled → 4
Pos 8
8
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 8 → 16 → 7 2 → 4 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 1 + 4 + 7 + 1 + 6 + 7 + 4 + 8 + 1 + 6 + 24 = 75

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 75 is 80. The difference is the calculated check digit.

80 - 75 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1477872885.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Otolaryngology
1035 N ORLANDO AVE STE 205
WINTER PARK, FL 32789
Otolaryngology (Otolaryngology/Facial Plastic Surgery)
1035 N ORLANDO AVE STE 205
WINTER PARK, FL 32789
Physician Assistant
1035 N ORLANDO AVE STE 205
WINTER PARK, FL 32789
Internal Medicine (Cardiovascular Disease)
1035 N ORLANDO AVE STE 205
WINTER PARK, FL 32789

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1477872885, enumerated as an "individual" on May 25, 2010.

The provider is located at 1035 N ORLANDO AVE STE 205 WINTER PARK, FL 32789 and the phone number is (321) 274-8701.

Internal Medicine with taxonomy code 207RI0011X and a focus in Interventional Cardiology.

The provider might be accepting Accepts: Ambetter from Superior HealthPlan, Ambetter. Please consult your insurance carrier or call the provider to verify.

Raghav Sharma is affiliated with: ADVENTHEALTH ORLANDO.