UMANG BARVALIA MBBS
NPI 1578827242
Internal Medicine - Pulmonary Disease in Madison, WI

Active since June 27, 2012PECOS EnrolledAccepts Medicare Assignment
80.58/100
CMS Quality Rating
600 HIGHLAND AVE, MADISON, WI 53792(608) 263-8023 Get Directions Write a Review

NPPES record last updated: January 6, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Umang Barvalia Mbbs NPPES

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

UMANG BARVALIA MBBS (NPI 1578827242) is an individual pulmonary disease provider in Madison, Wisconsin, licensed in Wisconsin (61411-20) and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS and is a graduate of Other (2010).

NPPES Registry Identity

NPI1578827242
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameUMANG BARVALIACredential: MBBS
Location Address600 HIGHLAND AVEMadison, WI 53792-0001
Mailing Address600 Highland AveMadison, WI 53792-0001 · (608) 263-8023
Sole ProprietorYes
Medical School CMSOtherGraduated 2010
Enumeration DateJune 27, 2012
Last NPPES UpdateJanuary 6, 2017
NPI 1578827242 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 WI · 61411-20
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.
600 HIGHLAND AVE, Madison, WI 53792

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

Umang Barvalia Mbbs 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 ID3779714381
PECOS Enrollment IDI20190102002835
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 10

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.

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.
168 services64 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.
79 services68 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.
66 services47 patients
Test to determine lung volumes using sensors 94726
This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.
43 services42 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.
42 services42 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.
32 services31 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53792 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

80.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality67.43
Promoting Interoperability100
Improvement Activities40
Cost46.5

Referred Medical Equipment & Supplies CMS DME claims 10

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

Tracheal suction catheter, any type other than closed system, each A4624
DME-Other DME · category DE000N
1 supplier13 claims1,140 services$2.54 avg. paid by Medicare
Oropharyngeal suction catheter, each A4628
DME-Other DME · category DE000N
1 supplier13 claims60 services$3.51 avg. paid by Medicare
Canister, disposable, used with suction pump, each A7000
DME-Other DME · category DE000N
1 supplier13 claims58 services$6.72 avg. paid by Medicare
Tubing, used with suction pump, each A7002
DME-Other DME · category DE000N
1 supplier14 claims62 services$3.52 avg. paid by Medicare
Tracheostomy tube collar/holder, each A7526
DME-Orthotic Devices · category DF000N
1 supplier12 claims495 services$3.26 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
4 suppliers39 claims41 services$14.26 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 20

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

Pharmacist
600 HIGHLAND AVE, COMPLIANCE MAIL CODE 2433
MADISON, WI 53792
Ophthalmology
600 HIGHLAND AVE
MADISON, WI 53792
Surgery
600 HIGHLAND AVE
MADISON, WI 53792
Internal Medicine (Infectious Disease)
600 HIGHLAND AVE
MADISON, WI 53792
Anesthesiology
600 HIGHLAND AVE
MADISON, WI 53792
Transplant Surgery
600 HIGHLAND AVE
MADISON, WI 53792
Anesthesiology
600 HIGHLAND AVE
MADISON, WI 53792
Radiology (Radiation Oncology)
600 HIGHLAND AVE
MADISON, WI 53792

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 Umang Barvalia's NPI number?

The NPI number for Umang Barvalia is 1578827242. It was assigned to this individual provider in the NPPES registry on June 27, 2012.

Where is Umang Barvalia located?

Umang Barvalia practices at 600 Highland Ave, Madison, WI 53792. The listed phone number is (608) 263-8023.

What is Umang Barvalia's specialty?

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

Is Umang Barvalia enrolled in Medicare?

Yes. Umang Barvalia 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.

When was this NPI record last updated?

The NPPES record for Umang Barvalia was last updated on January 6, 2017. 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.