DR. PRASHANT N PANDYA MD
NPI 1497738876
Internal Medicine in West Orange, NJ

Q: What is Prashant Pandya's NPI number?

The NPI number for Prashant Pandya is 1497738876. It was assigned to this individual provider in the NPPES registry on November 21, 2005.

Q: What is Prashant Pandya's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Prashant Pandya was last updated on November 21, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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 21, 2005PECOS EnrolledAccepts Medicare Assignment

449 MOUNT PLEASANT AVE, 1ST FLOOR, WEST ORANGE, NJ 07052(973) 731-7868 Get Directions Write a Review

NPPES record last updated: November 21, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Prashant N Pandya Md NPPES

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

DR. PRASHANT N PANDYA MD (NPI 1497738876) is an individual internal medicine provider in West Orange, New Jersey, licensed in New Jersey (25MA06751300) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Morristown Medical Center, and is a graduate of University Of Michigan Medical School (1992).

NPPES Registry Identity

NPI1497738876

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. PRASHANT N PANDYACredential: MD

Location Address449 MOUNT PLEASANT AVE, 1ST FLOORWest Orange, NJ 07052-2723

Mailing AddressPo Box 416457Boston, MA 02241-6457

Phone(973) 731-7868

Sole ProprietorNo

Medical School CMSUniversity Of Michigan Medical SchoolGraduated 1992

Enumeration DateNovember 21, 2005

Last NPPES UpdateNovember 21, 2016

✔ NPI 1497738876 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in NJ · 25MA06751300

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

449 MOUNT PLEASANT AVE, West Orange, NJ 07052

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Other Identifiers 3

Medicare ID-Type Unspecified036869NJ

Other223663587NJ · Commerical

Medicare UPING22933NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.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. Prashant N Pandya 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 ID3476648197

PECOS Enrollment IDI20091209000137

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 12

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.

736 services299 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.

244 services244 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.

230 services156 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

228 services219 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

176 services176 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.

92 services92 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

84 services82 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

76 services76 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

24 services23 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

24 services23 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

16 services16 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

14 services13 patients

Hospital Affiliations CMS Care Compare 5

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

Morristown Medical Center

Acute Care Hospitals · Morristown, NJ

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310015

Location100 Madison AveMorristown, NJ 07960 · Morris County

Emergency services Birthing friendly

Chilton Medical Center

Acute Care Hospitals · Pompton Plains, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310017

Location97 West ParkwayPompton Plains, NJ 07444 · Morris County

Emergency services Birthing friendly

Overlook Medical Center

Acute Care Hospitals · Summit, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310051

Location99 Beauvoir AvenueSummit, NJ 07901 · Union County

Emergency services Birthing friendly

Hackensack Meridian Health, Mountainside Medical

Acute Care Hospitals · Montclair, NJ

2/5 CMS rating

OwnershipProprietary

CMS Certification Number310054

Location1 Bay AvenueMontclair, NJ 07042 · Essex County

Emergency services Birthing friendly

Cooperman Barnabas Medical Center

Acute Care Hospitals · Livingston, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310076

Location94 Old Short Hills RoadLivingston, NJ 07039 · Essex County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07052 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

$144.86 typical visit price

range $63.84 – $190.92

Typical copayment $36.21 (range $15.96 – $47.73)

Most-billed visit code 99204

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

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 2

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

17 suppliers41 claims91 services$5.58 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

7 suppliers15 claims16 services$0.87 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 5

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

DR. JON DAVID GREEN M.D.

Internal Medicine (Gastroenterology)

449 MOUNT PLEASANT AVE, 2ND FLOOR
WEST ORANGE, NJ 07052

Essex County (973) 731-7868

THOMAS G HIGGINS M.D.

Internal Medicine (Cardiovascular Disease)

449 MOUNT PLEASANT AVE, 2ND FLOOR
WEST ORANGE, NJ 07052

Essex County (973) 731-7868

KAUSHIK CHHAGANLAL MODI M.D.

Internal Medicine (Cardiovascular Disease)

449 MOUNT PLEASANT AVE, 2ND FLOOR
WEST ORANGE, NJ 07052

Essex County (973) 731-7868

DANIEL KILHO LEE M.D.

Internal Medicine

449 MOUNT PLEASANT AVE
WEST ORANGE, NJ 07052

Essex County (973) 731-7868

BENNY CHU DO

Internal Medicine

449 MOUNT PLEASANT AVE, 1ST FLOOR
WEST ORANGE, NJ 07052

Essex County (973) 731-7868

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 Prashant Pandya's NPI number?

The NPI number for Prashant Pandya is 1497738876. It was assigned to this individual provider in the NPPES registry on November 21, 2005.

Where is Prashant Pandya located?

Prashant Pandya practices at 449 Mount Pleasant Ave 1st Floor, West Orange, NJ 07052. The listed phone number is (973) 731-7868.

What is Prashant Pandya's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Prashant Pandya enrolled in Medicare?

Yes. Prashant Pandya 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 Prashant Pandya accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Prashant Pandya 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 Prashant Pandya affiliated with any hospitals?

According to CMS data, Prashant Pandya is affiliated with Morristown Medical Center, Chilton Medical Center, Overlook Medical Center, Hackensack Meridian Health, Mountainside Medical and Cooperman Barnabas Medical Center.

When was this NPI record last updated?

The NPPES record for Prashant Pandya was last updated on November 21, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.