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WAQAS A GHUMMAN M.D.
NPI 1619931516
Internal Medicine - Advanced Heart Failure and Transplant Cardiology in Atlantis, FL

Active since April 17, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
180 JFK DR, SUITE 320, ATLANTIS, FL 33462(561) 548-4900(561) 434-5165 Get Directions Write a Review

NPPES record last updated: February 10, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Waqas A Ghumman M.d. NPPES

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

WAQAS A GHUMMAN M.D. (NPI 1619931516) is an individual advanced heart failure and transplant cardiology provider in Atlantis, Florida, licensed in Florida (ME126314) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Hca Florida Jfk Hospital, and is a graduate of Indiana University School Of Medicine (1996).

NPPES Registry Identity

NPI1619931516
Entity TypeIndividualMale
Primary Taxonomy207RA0001X
Provider Legal NameWAQAS A GHUMMANCredential: M.D.
Location Address180 JFK DR, SUITE 320Atlantis, FL 33462-6641
Mailing Address180 Jfk Dr, Suite 320Atlantis, FL 33462-6641 · (561) 548-4900 · Fax (561) 434-5165
Phone(561) 548-4900
Fax(561) 434-5165
Sole ProprietorNo
Medical School CMSIndiana University School Of MedicineGraduated 1996
Enumeration DateApril 17, 2006
Last NPPES UpdateFebruary 10, 2022
✔ NPI 1619931516 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyInternal Medicine · Advanced Heart Failure and Transplant CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code207RA0001X
License✔ Licensed in FL · ME126314
Definition
Specialists in Advanced Heart Failure and Transplant Cardiology would participate in the inpatient and outpatient management of patients with advanced heart failure across the spectrum from consideration for high-risk cardiac surgery, cardiac transplantation, or mechanical circulatory support, to pre-and post-operative evaluation and management of patients with cardiac transplants and mechanical support devices, and end-of-life care for patients with end-stage heart failure.
Also ListedTransplant SurgeryTaxonomy 204F00000X · License 01052070A (IN)
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X · License 01052070A (IN)
Also ListedInternal Medicine · Clinical Cardiac ElectrophysiologyTaxonomy 207RC0001X · License 01052070A (IN)
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 01052070A (IN)
Also ListedSurgery · Vascular SurgeryTaxonomy 2086S0129X · License 01052070A (IN)
180 JFK DR, Atlantis, FL 33462
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Other Identifiers 2

Medicaid200375660IN
OtherP01214639IN · Rr Medicare Ptan

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.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

Waqas A Ghumman M.d. 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 ID547335978
PECOS Enrollment IDI20160330001803
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 6

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 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.
168 services50 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.
102 services49 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.
60 services26 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.
53 services44 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.
38 services11 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
13 services13 patients

Hospital Affiliations CMS Care Compare

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

Hca Florida Jfk Hospital

Acute Care Hospitals · Atlantis, FL
2/5 CMS rating
OwnershipProprietary
CMS Certification Number100080
Location5301 S Congress AveAtlantis, FL 33462 · Palm Beach County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33462 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
$135.56 typical visit price
range $58.56 – $179.05
Typical copayment $33.89 (range $14.64 – $44.76)
Most-billed visit code 99204
Established Patient
$103.21 typical visit price
range $18.44 – $144.68
Typical copayment $25.80 (range $4.61 – $36.17)
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.

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

Referred Medical Equipment & Supplies CMS DME claims 3

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

Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) A4221
DME-Other DME · category DE017N
4 suppliers39 claims54 services$18.30 avg. paid by Medicare
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) A4222
DME-Medical/Surgical Supplies · category DA000N
4 suppliers50 claims324 services$35.18 avg. paid by Medicare
Injection, milrinone lactate, 5 mg J2260
Treatment-Injections and Infusions (nononcologic) · category RI026N
3 suppliers45 claims3,645 services$1.35 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.

MELISSA HOCHMAN
Physical Therapist
180 JFK DR
ATLANTIS, FL 33462
Palm Beach County (561) 967-6500
DR. FARAHNAZ ANGELLA MD
Internal Medicine (Clinical Cardiac Electrophysiology)
180 JFK DR, SUITE 311
ATLANTIS, FL 33462
Palm Beach County (561) 434-0353
KATHERINE MERRY M.D.
Internal Medicine
180 JFK DR, SUITE 210
ATLANTIS, FL 33462
Palm Beach County (561) 548-1450
ORTHOPEDIC CENTER OF PALM BEACH COUNTY, LLC
Specialist
180 JFK DR, STE 100
ATLANTIS, FL 33462
Palm Beach County (561) 967-6500
ORTHOPEDIC CENTER OF PALM BEACH COUNTY, LLC
Orthopaedic Surgery
180 JFK DR, SUITE 110
ATLANTIS, FL 33462
Palm Beach County (561) 967-6500
DR. GERARD DOMENIC D'ARIANO M.D.
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
180 JFK DR
ATLANTIS, FL 33462
Palm Beach County (561) 967-6500
DR. JAMES COOPER M.D.
Internal Medicine
180 JFK DR, SUITE 210
ATLANTIS, FL 33462
Palm Beach County (561) 548-1450
JENNIFER CACERES MD
Internal Medicine
180 JFK DR, SUITE 210
ATLANTIS, FL 33462
Palm Beach County (561) 548-1540

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 Waqas Ghumman's NPI number?

The NPI number for Waqas Ghumman is 1619931516. It was assigned to this individual provider in the NPPES registry on April 17, 2006.

Where is Waqas Ghumman located?

Waqas Ghumman practices at 180 Jfk Dr Suite 320, Atlantis, FL 33462. The listed phone number is (561) 548-4900.

What is Waqas Ghumman's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Advanced Heart Failure and Transplant Cardiology, with taxonomy code 207RA0001X.

Is Waqas Ghumman enrolled in Medicare?

Yes. Waqas Ghumman 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 Waqas Ghumman accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, AvMed and Florida Blue (BlueCross BlueShield FL) and 4 other insurers list Waqas Ghumman 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 Waqas Ghumman affiliated with any hospitals?

According to CMS data, Waqas Ghumman is affiliated with Hca Florida Jfk Hospital.

When was this NPI record last updated?

The NPPES record for Waqas Ghumman was last updated on February 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.