DR. MANISH GUGNANI MD
NPI 1558327221
Internal Medicine - Pulmonary Disease in Lawrenceville, NJ

Q: What is Manish Gugnani's NPI number?

The NPI number for Manish Gugnani is 1558327221. It was assigned to this individual provider in the NPPES registry on April 21, 2006.

Q: What is Manish Gugnani's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Manish Gugnani was last updated on April 30, 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 April 21, 2006PECOS EnrolledAccepts Medicare Assignment

19.96/100

CMS Quality Rating

3140 PRINCETON PIKE FL 2, LAWRENCEVILLE, NJ 08648(609) 403-6715(609) 403-6567 Get Directions Write a Review

NPPES record last updated: April 30, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 30, 2024, Jan 8, 2019 (2 updates tracked since 2019).

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About Dr. Manish Gugnani Md NPPES

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

DR. MANISH GUGNANI MD (NPI 1558327221) is an individual pulmonary disease provider in Lawrenceville, New Jersey, licensed in New Jersey (MA72229) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Capital Health Medical Center - Hopewell, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1558327221

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameDR. MANISH GUGNANICredential: MD

Location Address3140 PRINCETON PIKE FL 2Lawrenceville, NJ 08648-2330

Mailing Address3140 Princeton Pike Fl 2Lawrenceville, NJ 08648-2330 · (609) 403-6715 · Fax (609) 403-6567

Phone(609) 403-6715

Fax(609) 403-6567

Sole ProprietorYes

Medical School CMSOtherGraduated 1990

Enumeration DateApril 21, 2006

Last NPPES UpdateApril 30, 20242 updates tracked since enumeration

NPPES CertifiedApril 30, 2024

✔ NPI 1558327221 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in NJ · MA72229

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 25MA07222900 (NJ)

3140 PRINCETON PIKE FL 2, Lawrenceville, NJ 08648

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Secondary Practice Locations 2

Location 1416 Bellevue Ave, suite 405Trenton, NJ 08618-4513 · Phone (609) 394-2900

Location 2750 Brunswick AveTrenton, NJ 08638-4143 · Phone (609) 394-6000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Manish Gugnani 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 ID6800856360

PECOS Enrollment IDI20041019000317

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.

Medicare Billing Reassignments

Medicare enrollment records show Manish Gugnani reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Capital Health Medical Group

3.8 mi

Internal Medicine

750 BRUNSWICK AVE
Trenton, NJ 08638

Reassigned Medicare billing, New Jersey enrollment
581 clinicians in this Medicare group

NPI 1437516887 (609) 815-7829

Capital Health Multispecialty Group

3.8 mi

Surgery

750 BRUNSWICK AVE
Trenton, NJ 08638

Reassigned Medicare billing, New Jersey enrollment
600 clinicians in this Medicare group

NPI 1083072342 (609) 394-6000

State Of New Jersey Omb Centralized Payroll

5.6 mi

Psychiatric Hospital

101 SULLIVAN WAY
Trenton, NJ 08628

Reassigned Medicare billing, New Jersey enrollment
70 clinicians in this Medicare group

NPI 1467552240 (609) 633-1562

Advanced Pulmonary Critical Care MD PC

9.8 mi

Pulmonary Disease

7 OLIVIA RD
Hightstown, NJ 08520

Reassigned Medicare billing, New Jersey enrollment
2 clinicians in this Medicare group

NPI 1063307775 (609) 851-2006

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 14

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.

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.

293 services115 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

221 services68 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.

125 services64 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.

72 services15 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.

67 services14 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

65 services60 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.

35 services35 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.

34 services34 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.

31 services31 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.

31 services31 patients

Critical care, each additional 30 minutes 99292

Critical care refers to special attention given to patients facing life-threatening conditions. Each additional 30 minutes indicates the extension of this specialized care. This might include close monitoring, medication adjustments, and immediate interventions as needed.

27 services18 patients

Test to determine lung volumes using gas dilution or washout 94727

This test measures lung volumes by either diluting or washing out a known amount of gas in your lungs. You'll breathe in a harmless gas, then exhale. The exhaled air is analyzed to assess your lung capacity and function.

24 services24 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.

21 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.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Capital Health Medical Center - Hopewell

Acute Care Hospitals · Pennington, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310044

LocationOne Capital WayPennington, NJ 08534 · Mercer County

Emergency services Birthing friendly

Capital Health Regional Medical Center

Acute Care Hospitals · Trenton, NJ

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310092

Location750 Brunswick AveTrenton, NJ 08638 · Mercer County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08648 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

$140.34 typical visit price

range $61.59 – $185.05

Typical copayment $35.08 (range $15.39 – $46.26)

Most-billed visit code 99204

Established Patient

$107.94 typical visit price

range $20.08 – $150.98

Typical copayment $26.98 (range $5.02 – $37.74)

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.

19.96/100

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

Individually scored

Quality

Improvement Activities

Cost

66.55

Reported Quality Measures

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

0%256 patients1/55-star benchmark: 85%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

46%405 patients1/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

97%178 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

6%463 patients1/55-star benchmark: 99%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

2%179 patients1/55-star benchmark: 90%

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

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

83%405 patients4/55-star benchmark: 97%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

1%393 patients1/55-star benchmark: 88%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

33%463 patients2/55-star benchmark: 100%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

98%168 patients1/55-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 14

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