DR. NISHA A. RUGHWANI M.D,
NPI 1487782025
Family Medicine in New York, NY

Q: What is Nisha Rughwani's NPI number?

The NPI number for Nisha Rughwani is 1487782025. It was assigned to this individual provider in the NPPES registry on March 2, 2007.

Q: What is Nisha Rughwani's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Nisha Rughwani was last updated on March 25, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 02, 2007PECOS EnrolledAccepts Medicare Assignment

1440 MADISON AVE, NEW YORK, NY 10029(212) 659-8552(212) 426-0349 Get Directions Write a Review

NPPES record last updated: March 25, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Nisha A. Rughwani M.d, NPPES

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

DR. NISHA A. RUGHWANI M.D, (NPI 1487782025) is an individual family medicine provider in New York, New York, licensed in New York (242206) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS, is affiliated with Mount Sinai Hospital, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1487782025

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. NISHA A. RUGHWANICredential: M.D,

Location Address1440 MADISON AVENew York, NY 10029-6508

Mailing AddressPo Box 28082New York, NY 10087-8082 · (212) 987-3100 · Fax (212) 731-5210

Phone(212) 659-8552

Fax(212) 426-0349

Sole ProprietorNo

Medical School CMSOtherGraduated 1998

Enumeration DateMarch 2, 2007

Last NPPES UpdateMarch 25, 2014

✔ NPI 1487782025 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NY · 242206

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.

1440 MADISON AVE, New York, NY 10029

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Other Identifiers 3

Medicaid02858120NY

Medicare ID-Type Unspecified56 P2409821NY

Medicare UPINI71426NY

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. Nisha A. Rughwani 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 ID8224134721

PECOS Enrollment IDI20070430000378

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 16

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 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.

425 services176 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

117 services71 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

56 services56 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.

54 services36 patients

Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month 99487

Complex chronic care management is a service for patients with two or more long-term health conditions. It involves a healthcare professional directing clinical staff in providing care for the first 60 minutes each month. This helps manage your health conditions effectively.

46 services28 patients

Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month 99489

Complex chronic care management is a service for patients with multiple chronic conditions. It involves an additional 60 minutes per month of clinical staff time directed by a healthcare professional. This service assists in managing your health conditions effectively.

41 services12 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

37 services28 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

26 services13 patients

Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a G0179

This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.

22 services16 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

17 services17 patients

Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) G0506

This service involves a thorough evaluation of patients needing ongoing care for chronic conditions. It includes creating a tailored care plan, coordinating with healthcare providers, and monitoring progress regularly. The goal is to provide optimal, personalized care for your long-term health needs.

14 services13 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

13 services13 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

13 services12 patients

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.

12 services12 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.

11 services11 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Mount Sinai Hospital

Acute Care Hospitals · New York, NY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330024

LocationOne Gustave L Levy PlaceNew York, NY 10029 · New York County

Emergency services Birthing friendly

Mount Sinai St Luke's Roosevelt Hospital

Acute Care Hospitals · New York, NY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330046

Location1000 Tenth AvenueNew York, NY 10019 · New York County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10029 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

$102.04 typical visit price

range $65.69 – $198.19

Typical copayment $25.51 (range $16.42 – $49.54)

Most-billed visit code 99203

Established Patient

$114.88 typical visit price

range $21.20 – $160.66

Typical copayment $28.72 (range $5.30 – $40.16)

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 4

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

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

DME-Other DME · category DE017N

4 suppliers15 claims27 services$5.78 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

1 supplier30 claims30 services$36.55 avg. paid by Medicare

Lightweight wheelchair K0003

DME-Wheelchairs · category DD000N

1 supplier43 claims43 services$17.59 avg. paid by Medicare

Elevating leg rests, pair (for use with capped rental wheelchair base) K0195

DME-Wheelchairs · category DD021N

2 suppliers35 claims35 services$5.59 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.

HELEN FERNANDEZ MD

Internal Medicine (Geriatric Medicine)