IRFAN BUDHANI MD
NPI 1609079540
Internal Medicine - Pulmonary Disease in Florence, KY

Active since June 07, 2007PECOS EnrolledAccepts Medicare Assignment
90.38/100
CMS Quality Rating
4900 HOUSTON RD, FLORENCE, KY 41042(859) 212-7700(859) 212-7710 Get Directions Write a Review

NPPES record last updated: September 12, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 12, 2018, Sep 1, 2017, Jun 14, 2017 (3 updates tracked since 2017).

About Irfan Budhani Md NPPES

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

IRFAN BUDHANI MD (NPI 1609079540) is an individual pulmonary disease provider in Florence, Kentucky, licensed in Kentucky (42528) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS, is affiliated with St Elizabeth Dearborn Hospital, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1609079540
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameIRFAN BUDHANICredential: MD
Location Address4900 HOUSTON RDFlorence, KY 41042-4824
Mailing AddressPo Box 635283Cincinnati, OH 45263-5283 · (859) 212-7700 · Fax (859) 212-7710
Fax(859) 212-7710
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateJune 7, 2007
Last NPPES UpdateSeptember 12, 20183 updates tracked since enumeration
NPI 1609079540 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
Licenses Licensed in KY · 42528 Licensed in OH · 57006900
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 42528 (KY)
4900 HOUSTON RD, Florence, KY 41042

Other Identifiers 3

OtherP00795885KY · Railroad Medicare
Medicaid7100097010KY
Medicaid3081310OH

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

Irfan Budhani 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 ID7113070426
PECOS Enrollment IDI20090804000770
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 20

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.
313 services199 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.
275 services145 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.
178 services77 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
105 services79 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.
92 services92 patients
Computer-assisted image-guided navigation of lung airways using an endoscope 31627
This procedure involves the use of a special camera, called an endoscope, and computer technology to create real-time images of your lung airways. This helps doctors navigate through your lungs accurately, aiding in diagnosis or treatment.
79 services79 patients

Hospital Affiliations CMS Care Compare 5

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

St Elizabeth Dearborn Hospital

Acute Care Hospitals · Lawrenceburg, IN
5/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number150086
Location600 Wilson Creek RdLawrenceburg, IN 47025 · Dearborn County
Emergency services Birthing friendly

St Elizabeth Ft Thomas

Acute Care Hospitals · Fort Thomas, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180001
Location85 North Grand AvenueFort Thomas, KY 41075 · Campbell County
Emergency services

St Elizabeth Edgewood

Acute Care Hospitals · Edgewood, KY
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number180035
Location1 Medical Village DriveEdgewood, KY 41017 · Kenton County
Emergency services Birthing friendly

St Elizabeth Florence

Acute Care Hospitals · Florence, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180045
Location4900 Houston RoadFlorence, KY 41042 · Boone County
Emergency services

St Elizabeth Grant

Critical Access Hospitals · Williamstown, KY
OwnershipVoluntary non-profit - Church
CMS Certification Number181311
Location238 Barnes RoadWilliamstown, KY 41097 · Grant County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41042 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
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

90.38/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.76
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
71%102 patients3/55-star benchmark: 100%
Medication Reconciliation Post-Discharge
The percentage of discharges from any inpatient facility (e.g. hospital, skilled nursing facility, or rehabilitation facility) for patients 18 years and older of age seen within 30 days following discharge in the office by the physician, prescribing…
Patients 65+: 100% · 31 patients
100%39 patients
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
95%148 patients4/55-star benchmark: 100%
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…
32%197 patients2/55-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 10

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
7 suppliers42 claims42 services$14.37 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
2 suppliers11 claims11 services$767.77 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
5 suppliers43 claims43 services$5.19 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
11 suppliers107 claims107 services$60.29 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
5 suppliers53 claims53 services$29.18 avg. paid by Medicare
Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms J7606
DME-Drugs Administered Through DME · category DG006N
1 supplier12 claims720 services$6.34 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.

Hospitalist
4900 HOUSTON RD
FLORENCE, KY 41042
Hospitalist
4900 HOUSTON RD
FLORENCE, KY 41042
Hospitalist
4900 HOUSTON RD
FLORENCE, KY 41042
Internal Medicine (Gastroenterology)
4900 HOUSTON RD
FLORENCE, KY 41042
Registered Nurse
4900 HOUSTON RD
FLORENCE, KY 41042
Nurse Practitioner
4900 HOUSTON RD
FLORENCE, KY 41042
Nurse Practitioner
4900 HOUSTON RD
FLORENCE, KY 41042
Physician Assistant
4900 HOUSTON RD
FLORENCE, KY 41042

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 Irfan Budhani's NPI number?

The NPI number for Irfan Budhani is 1609079540. It was assigned to this individual provider in the NPPES registry on June 7, 2007.

Where is Irfan Budhani located?

Irfan Budhani practices at 4900 Houston Rd, Florence, KY 41042. The listed phone number is (859) 212-7700.

What is Irfan Budhani's specialty?

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

Is Irfan Budhani enrolled in Medicare?

Yes. Irfan Budhani 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 Irfan Budhani accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and CareSource list Irfan Budhani 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 Irfan Budhani affiliated with any hospitals?

According to CMS data, Irfan Budhani is affiliated with St Elizabeth Dearborn Hospital, St Elizabeth Ft Thomas, St Elizabeth Edgewood, St Elizabeth Florence and St Elizabeth Grant.

When was this NPI record last updated?

The NPPES record for Irfan Budhani was last updated on September 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.