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RACHANA SEDHAI MD
NPI 1609217884
Internal Medicine in Pawtucket, RI

Active since July 16, 2013PECOS EnrolledAccepts Medicare Assignment
111 BREWSTER ST, PAWTUCKET, RI 02860(401) 729-2258(401) 729-3343 Get Directions Write a Review

NPPES record last updated: July 16, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Rachana Sedhai Md NPPES

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

RACHANA SEDHAI MD (NPI 1609217884) is an individual internal medicine provider in Pawtucket, Rhode Island, licensed in Rhode Island (LP02889) and active in the NPI registry since July 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1609217884
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameRACHANA SEDHAICredential: MD
Location Address111 BREWSTER STPawtucket, RI 02860-4474
Mailing Address111 Brewster StPawtucket, RI 02860-4474 · (401) 729-2258 · Fax (401) 729-3343
Phone(401) 729-2258
Fax(401) 729-3343
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateJuly 16, 2013
✔ NPI 1609217884 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in RI · LP02889
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
111 BREWSTER ST, Pawtucket, RI 02860
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).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

Rachana Sedhai 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 ID8628206869
PECOS Enrollment IDI20160921000772
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 11

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.

Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes 99350
An established patient home visit is a service where a healthcare professional visits a patient's home for a check-up or treatment. The visit typically lasts for about an hour. This service is especially beneficial for patients who may have difficulty traveling to a healthcare facility.
423 services81 patients
Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month 99487
Complex chronic care management is a service for patients with two or more long-term health conditions. It involves a healthcare professional directing clinical staff in providing care for the first 60 minutes each month. This helps manage your health conditions effectively.
394 services77 patients
Care management services for behavioral health conditions, 20 minutes or more clinical staff time directed by health care professional 99484
Care management for behavioral health involves a healthcare professional directing clinical staff to provide you with support for 20 minutes or more. This service can include planning your care, coordinating services, and managing your health conditions to improve your overall well-being.
291 services60 patients
Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) G0506
This service involves a thorough evaluation of patients needing ongoing care for chronic conditions. It includes creating a tailored care plan, coordinating with healthcare providers, and monitoring progress regularly. The goal is to provide optimal, personalized care for your long-term health needs.
48 services48 patients
Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes 99345
A new patient home visit is a comprehensive 75-minute appointment conducted at your home. The healthcare professional will assess your health, discuss any concerns, and create a personalized care plan. It's convenient, comfortable, and tailored to your specific needs.
47 services47 patients
Assessment of and care planning for patient with impaired thought processing, typically 60 minutes 99483
This service involves a thorough evaluation of your thought processes, which may be impacting your daily life. In a typical 50-minute session, a healthcare professional will assess your cognitive abilities, identify any areas of concern, and develop a personalized care plan to help improve your mental function.
43 services39 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02860 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
$134.17 typical visit price
range $58.57 – $177.03
Typical copayment $33.54 (range $14.64 – $44.25)
Most-billed visit code 99204
Established Patient
$103.10 typical visit price
range $18.92 – $144.38
Typical copayment $25.77 (range $4.73 – $36.09)
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.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
78%151 patients4/55-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

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
1 supplier11 claims11 services$4.99 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.

MAHMOUD MOWAFY M.D.
Internal Medicine
111 BREWSTER ST
PAWTUCKET, RI 02860
Providence County (401) 729-2258
ASHLEY NANCY MASTRANGELO DPM
Podiatrist (Foot & Ankle Surgery)
111 BREWSTER ST
PAWTUCKET, RI 02860
Providence County (401) 729-2977
JOHN RIEDEL MD
Emergency Medicine
111 BREWSTER ST, DEPARTMENT OF EMERGENCY MEDICINE
PAWTUCKET, RI 02860
Providence County (401) 729-2191
MEMORIAL HOSPITAL
General Acute Care Hospital
111 BREWSTER ST
PAWTUCKET, RI 02860
Providence County (401) 729-2836
JALEH FALLAH MD
Internal Medicine (Hematology & Oncology)
111 BREWSTER ST
PAWTUCKET, RI 02860
Providence County (401) 729-2258
MS. COLLEEN FOLEY-LUNT
Speech-Language Pathologist
111 BREWSTER ST, SPEECH LANGUAGE PATHOLOGY
PAWTUCKET, RI 02860
Providence County (508) 729-2316
MAXWELL VAN HOVEN MD
Family Medicine
111 BREWSTER ST
PAWTUCKET, RI 02860
Providence County (401) 737-7000
SCOTT MICHAEL CAMPBELL
Physical Therapist
111 BREWSTER ST, ND PHYSICAL THERAPY
PAWTUCKET, RI 02860
Providence County (401) 729-3481

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 Rachana Sedhai's NPI number?

The NPI number for Rachana Sedhai is 1609217884. It was assigned to this individual provider in the NPPES registry on July 16, 2013.

Where is Rachana Sedhai located?

Rachana Sedhai practices at 111 Brewster St, Pawtucket, RI 02860. The listed phone number is (401) 729-2258.

What is Rachana Sedhai's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Rachana Sedhai enrolled in Medicare?

Yes. Rachana Sedhai 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 Rachana Sedhai accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Rachana Sedhai 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.

When was this NPI record last updated?

The NPPES record for Rachana Sedhai was last updated on July 16, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.