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DR. RAZA ALI MD
NPI 1619933074
Internal Medicine - Nephrology in Louisville, KY

Active since April 25, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
234 E GRAY ST, SUITE 858, LOUISVILLE, KY 40202(502) 583-1799(502) 583-1792 Get Directions Write a Review

NPPES record last updated: December 11, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Raza Ali Md NPPES

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

DR. RAZA ALI MD (NPI 1619933074) is an individual nephrology provider in Louisville, Kentucky, licensed in Kentucky (42311) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Floyd, and maintains a secondary practice location in Lafayette.

NPPES Registry Identity

NPI1619933074
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameDR. RAZA ALICredential: MD
Location Address234 E GRAY ST, SUITE 858Louisville, KY 40202-1900
Mailing Address234 E Gray St Ste 858Louisville, KY 40202-1927 · (502) 583-1799 · Fax (502) 583-1792
Phone(502) 583-1799
Fax(502) 583-1792
Sole ProprietorNo
Medical School CMSOtherGraduated 1987
Enumeration DateApril 25, 2006
Last NPPES UpdateDecember 11, 2025
NPPES CertifiedDecember 11, 2025
✔ NPI 1619933074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Licenses✔ Licensed in KY · 42311✔ Licensed in IN · 01066017A
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
234 E GRAY ST, Louisville, KY 40202
Open in Google Maps ↗

Secondary Practice Location 1

Location 13920 St Francis Way Ste 220Lafayette, IN 47905-4922 · Phone (765) 428-5950 · Fax (765) 428-5952

Other Identifiers 4

Other50022057KY · Passport Health Plan/medicaid Ky
Other000000592485KY · Anthem Bc/bs
Other3691858000KY · Passport Advantage/medicare
Medicaid200928550AIN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Raza Ali 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 ID5597705459
PECOS Enrollment IDI20081204000013, I20090110000053
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.

Medicare Billing Reassignments

7

Medicare enrollment records show Raza Ali reassigns Medicare billing to 7 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Bluegrass Kidney Consultants Psc
0.2 mi
Nephrology
721 S PRESTON ST FL 2
Louisville, KY 40203
  • Reassigned Medicare billing, Indiana and Kentucky enrollments
  • 13 clinicians in this Medicare group
NPI 1558500918 (502) 583-1799
New Albany Hospitalist Group, LLC
5.9 mi
Hospitalist
1850 STATE ST
New Albany, IN 47150
  • Reassigned Medicare billing, Indiana enrollment
  • 163 clinicians in this Medicare group
NPI 1255084752 (812) 944-7701
Owensboro Health Medical Group, Inc.
53 mi
Family Medicine
9847 ELIZABETHTOWN RD
Big Clifty, KY 42712
  • Reassigned Medicare billing, Kentucky enrollment
  • 643 clinicians in this Medicare group
NPI 1093311318 (270) 242-2000
Commonwealth Health Corporation, Inc.
94 mi
Infectious Disease
720 2ND AVE STE 307
Bowling Green, KY 42101
  • Reassigned Medicare billing, Kentucky enrollment
  • 319 clinicians in this Medicare group
NPI 1457779795 (270) 780-2760
Franciscan Physician Network
98 mi
Family Medicine
8111 S EMERSON AVE
Indianapolis, IN 46237
  • Reassigned Medicare billing, Indiana enrollment
  • 1,396 clinicians in this Medicare group
NPI 1225327984 (317) 528-4800
Apogee Medical Group Kentucky Psc
128 mi
General Practice
1 TRILLIUM WAY, SUITE 5
Corbin, KY 40701
  • Reassigned Medicare billing, Kentucky enrollment
  • 93 clinicians in this Medicare group
NPI 1356503114 (606) 528-1212
Pikeville Medical Center Inc.
180 mi
Clinic/Center
148 SUITE A, WHITESBURG PLAZA
Whitesburg, KY 41858
  • Reassigned Medicare billing, Kentucky enrollment
  • 579 clinicians in this Medicare group
NPI 1801106281 (606) 218-3500

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

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.
987 services264 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.
273 services127 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
181 services67 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.
132 services123 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.
32 services21 patients

Hospital Affiliations CMS Care Compare 5

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

Baptist Health Floyd

Acute Care Hospitals · New Albany, IN
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150044
Location1850 State StNew Albany, IN 47150 · Floyd County
Emergency services Birthing friendly

Franciscan Health Lafayette

Acute Care Hospitals · Lafayette, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number150109
Location1701 S Creasy LnLafayette, IN 47905 · Tippecanoe County
Emergency services Birthing friendly

The Medical Center (bowling Green)

Acute Care Hospitals · Bowling Green, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180013
Location250 Park StreetBowling Green, KY 42101 · Warren County
Emergency services Birthing friendly

Norton Hospitals, Inc

Acute Care Hospitals · Louisville, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180088
Location200 East Chestnut StreetLouisville, KY 40202 · Jefferson County
Emergency services Birthing friendly

Baptist Health Louisville

Acute Care Hospitals · Louisville, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180130
Location4000 Kresge WayLouisville, KY 40207 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40202 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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Reported Quality Measures

Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
100%63 patients5/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%1,285 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
53%331 patients2/55-star benchmark: 100%
Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet
Percentage of patients 18 years of age and older who were diagnosed with acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous coronary interventions (PCI) in the 12 months prior to the measurement period, or who had an active…
79%28 patients3/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
98%300 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
4%238 patients1/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
83%347 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
95%238 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
1%238 patients1/55-star benchmark: 79%
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.

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.

UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION
Orthopaedic Surgery
234 E GRAY ST, SUITE 564
LOUISVILLE, KY 40202
Jefferson County (502) 629-5460
JOHN JOSEPH GUARNASCHELLI MD
Neurological Surgery
234 E GRAY ST, SUITE 768
LOUISVILLE, KY 40202
Jefferson County (502) 584-4121
NORTON HOSPITALS INC
General Acute Care Hospital
234 E GRAY ST, STE 225
LOUISVILLE, KY 40202
Jefferson County (502) 629-8000
AMERICAN HOME DIALYSIS, LLC
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
234 E GRAY ST, SUITE 858
LOUISVILLE, KY 40202
Jefferson County (513) 673-5245
UNIVERSITY OF LOUISVILLE PHYSICIANS, INC.
Pediatrics (Pediatric Pulmonology)
234 E GRAY ST, SUITE 270
LOUISVILLE, KY 40202
Jefferson County (502) 629-8830
UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION INC.
Orthopaedic Surgery
234 E GRAY ST, SUITE 564
LOUISVILLE, KY 40202
Jefferson County (502) 629-5460
ANTHONY J. CASALE M.D.
Specialist
234 E GRAY ST, SUITE 662
LOUISVILLE, KY 40202
Jefferson County (502) 629-4220
DAVID R RAPER M.D.
General Practice
234 E GRAY ST, STE 334-B
LOUISVILLE, KY 40202
Jefferson County (502) 629-1750

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 Raza Ali's NPI number?

The NPI number for Raza Ali is 1619933074. It was assigned to this individual provider in the NPPES registry on April 25, 2006.

Where is Raza Ali located?

Raza Ali practices at 234 E Gray St Suite 858, Louisville, KY 40202. The listed phone number is (502) 583-1799.

What is Raza Ali's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Raza Ali enrolled in Medicare?

Yes. Raza Ali 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.

Which organizations bill Medicare for Raza Ali's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Raza Ali reassigns Medicare benefits to 7 organizations: Bluegrass Kidney Consultants Psc (Louisville, KY), New Albany Hospitalist Group, LLC (New Albany, IN), Owensboro Health Medical Group, Inc. (Big Clifty, KY), Commonwealth Health Corporation, Inc. (Bowling Green, KY), Franciscan Physician Network (Indianapolis, IN) and 2 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Raza Ali's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Raza Ali accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield and 1 other insurer list Raza Ali 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 Raza Ali affiliated with any hospitals?

According to CMS data, Raza Ali is affiliated with Baptist Health Floyd, Franciscan Health Lafayette, The Medical Center (bowling Green), Norton Hospitals, Inc and Baptist Health Louisville.

When was this NPI record last updated?

The NPPES record for Raza Ali was last updated on December 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.