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BALAKRISHNA R RAGOOR MD
NPI 1568436152
Family Medicine in Monroeville, PA

Active since February 13, 2006PECOS Enrolled
93.78/100
CMS Quality Rating
4217 NORTHERN PIKE, MONROEVILLE, PA 15146(412) 372-9100(412) 372-6952 Get Directions Write a Review

NPPES record last updated: July 17, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 17, 2023, Oct 11, 2020 (2 updates tracked since 2020).

About Balakrishna R Ragoor Md NPPES

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

BALAKRISHNA R RAGOOR MD (NPI 1568436152) is an individual family medicine provider in Monroeville, Pennsylvania, licensed in Pennsylvania (MD042607L) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1568436152
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameBALAKRISHNA R RAGOORCredential: MD
Location Address4217 NORTHERN PIKEMonroeville, PA 15146-2713
Mailing Address4217 Northern PikeMonroeville, PA 15146-2713 · (412) 372-9100 · Fax (412) 372-6952
Phone(412) 372-9100
Fax(412) 372-6952
Sole ProprietorYes
Enumeration DateFebruary 13, 2006
Last NPPES UpdateJuly 17, 20232 updates tracked since enumeration
NPPES CertifiedJuly 17, 2023
✔ NPI 1568436152 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in PA · MD042607L
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.
4217 NORTHERN PIKE, Monroeville, PA 15146
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Other Identifiers 1

Medicaid001237169PA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Balakrishna R Ragoor Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 2

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.
43 services32 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.
24 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15146 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

93.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.07
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
100%74 patients5/55-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 5

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

Nebulizer, with compressor E0570
DME-Other DME · category DE000N
3 suppliers19 claims19 services$4.06 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier15 claims15 services$59.73 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$26.40 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
2 suppliers19 claims19 services$204.75 avg. paid by Medicare
Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds K0821
DME-Wheelchairs · category DD009N
1 supplier11 claims11 services$143.98 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.

ALLEGHENY CLINIC
Internal Medicine
4217 NORTHERN PIKE
MONROEVILLE, PA 15146
Allegheny County (412) 372-9100
MARLA M PETERMAN CRNP
Nurse Practitioner (Family)
4217 NORTHERN PIKE
MONROEVILLE, PA 15146
Allegheny County (412) 372-9100
RAGOOR FAMILY PRACTICE LLC
Family Medicine (Adult Medicine)
4217 NORTHERN PIKE
MONROEVILLE, PA 15146
Allegheny County (412) 699-5993
MARK STEPHEN TOMICH JR. PA-C
Physician Assistant
4217 NORTHERN PIKE
MONROEVILLE, PA 15146
Allegheny County (412) 372-9100

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 Balakrishna Ragoor's NPI number?

The NPI number for Balakrishna Ragoor is 1568436152. It was assigned to this individual provider in the NPPES registry on February 13, 2006.

Where is Balakrishna Ragoor located?

Balakrishna Ragoor practices at 4217 Northern Pike, Monroeville, PA 15146. The listed phone number is (412) 372-9100.

What is Balakrishna Ragoor's specialty?

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

Is Balakrishna Ragoor enrolled in Medicare?

Yes. Balakrishna Ragoor is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Balakrishna Ragoor was last updated on July 17, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.