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

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: July 26, 2026.

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

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
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

Secondary Practice Locations 2

Location 1750 Brunswick AveTrenton, NJ 08638-4143 · Phone (609) 394-6000
Location 2416 Bellevue Ave, suite 405Trenton, NJ 08618-4513 · Phone (609) 394-2900

Accepted 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. 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.

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

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
Quality0
Improvement Activities0
Cost66.55

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
DME-Other DME · category DE001N
4 suppliers16 claims16 services$37.30 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
9 suppliers29 claims29 services$82.68 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
9 suppliers27 claims66 services$30.51 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
4 suppliers15 claims82 services$16.61 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
6 suppliers22 claims22 services$54.63 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
10 suppliers30 claims30 services$16.60 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 4

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

Internal Medicine (Cardiovascular Disease)
3140 PRINCETON PIKE FL 2
LAWRENCEVILLE, NJ 08648
Nurse Practitioner
3140 PRINCETON PIKE FL 2
LAWRENCEVILLE, NJ 08648
Nurse Practitioner (Family)
3140 PRINCETON PIKE FL 2
LAWRENCEVILLE, NJ 08648
Internal Medicine (Cardiovascular Disease)
3140 PRINCETON PIKE FL 2
LAWRENCEVILLE, NJ 08648

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 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.

Where is Manish Gugnani located?

Manish Gugnani practices at 3140 Princeton Pike Fl 2, Lawrenceville, NJ 08648. The listed phone number is (609) 403-6715.

What is Manish Gugnani's specialty?

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

Is Manish Gugnani enrolled in Medicare?

Yes. Manish Gugnani 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 Manish Gugnani accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Manish Gugnani 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 Manish Gugnani affiliated with any hospitals?

According to CMS data, Manish Gugnani is affiliated with Capital Health Medical Center - Hopewell and Capital Health Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Manish Gugnani was last updated on April 30, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.