DR. SANJAY BAKUL PANDYA M.D.
NPI 1639277353
Internal Medicine - Interventional Cardiology in Harker Heights, TX

Active since September 20, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
800 W CENTRAL TEXAS EXPY, SUITE 355, HARKER HEIGHTS, TX 76548(254) 526-2085(254) 526-9569 Get Directions Write a Review

NPPES record last updated: November 4, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Sanjay Bakul Pandya M.d. NPPES

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

DR. SANJAY BAKUL PANDYA M.D. (NPI 1639277353) is an individual interventional cardiology provider in Harker Heights, Texas, licensed in Texas (N9478) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Adventhealth Central Texas, and is a graduate of Rush Medical College Of Rush University (2003).

NPPES Registry Identity

NPI1639277353
Entity TypeIndividualMale
Primary Taxonomy207RI0011X
Provider Legal NameDR. SANJAY BAKUL PANDYACredential: M.D.
Location Address800 W CENTRAL TEXAS EXPY, SUITE 355Harker Heights, TX 76548-1899
Mailing Address7800 Shoal Creek Blvd, Suite 205nAustin, TX 78757-1098 · (512) 206-4341 · Fax (512) 407-1947
Fax(254) 526-9569
Sole ProprietorYes
Medical School CMSRush Medical College Of Rush UniversityGraduated 2003
Enumeration DateSeptember 20, 2006
Last NPPES UpdateNovember 4, 2014
NPI 1639277353 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Interventional CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code207RI0011X
License Licensed in TX · N9478
Definition
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X · License N9478 (TX)
800 W CENTRAL TEXAS EXPY, Harker Heights, TX 76548

Other Identifiers 2

Medicare PIN276372YKZXTX
Medicare PIN276372YNTUTX

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

Dr. Sanjay Bakul Pandya 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 ID9335310010
PECOS Enrollment IDI20110929000487
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 39

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 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.
542 services325 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.
247 services191 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.
241 services109 patients
Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152
This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.
223 services181 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
183 services177 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
169 services160 patients

Hospital Affiliations CMS Care Compare 5

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

Adventhealth Central Texas

Acute Care Hospitals · Killeen, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number450152
Location2201 S Clear Creek RoadKilleen, TX 76542 · Bell County
Emergency services Birthing friendly

St David's Medical Center

Acute Care Hospitals · Austin, TX
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450431
Location919 E 32nd StAustin, TX 78705 · Travis County
Emergency services Birthing friendly

Round Rock Medical Center

Acute Care Hospitals · Round Rock, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number450718
Location2400 Round Rock AveRound Rock, TX 78681 · Williamson County
Emergency services Birthing friendly

Cedar Park Regional Medical Center

Acute Care Hospitals · Cedar Park, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number670043
Location1401 Medical ParkwayCedar Park, TX 78613 · Williamson County
Emergency services Birthing friendly

Seton Medical Center Harker Heights

Acute Care Hospitals · Harker Heights, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number670080
Location850 W Central Texas ExpresswayHarker Heights, TX 76548 · Bell County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76548 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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
Individually scored

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
77%146 patients4/55-star benchmark: 99%
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.
97%2,265 patients4/55-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.
96%1,141 patients4/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
96%735 patients4/55-star benchmark: 99%
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%2,018 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.
100%1,537 patients5/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
49%735 patients3/55-star benchmark: 90%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
57%627 patients3/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 617 patients
Patients tobacco: 94% · 617 patients
42%69 patients2/55-star benchmark: 98%
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…
100%1,537 patients5/55-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…
55%1,537 patients3/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 735 patients
0%735 patients5/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
47%1,537 patients
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 15

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

Nurse Practitioner
800 W CENTRAL TEXAS EXPY, STE 125
HARKER HEIGHTS, TX 76548
Orthopaedic Surgery
800 W CENTRAL TEXAS EXPY, SUITE 175
HARKER HEIGHTS, TX 76548
Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery)
800 W CENTRAL TEXAS EXPY, SUITE 175
HARKER HEIGHTS, TX 76548
Family Medicine
800 W CENTRAL TEXAS EXPY, 125
HARKER HEIGHTS, TX 76548
Internal Medicine
800 W CENTRAL TEXAS EXPY, SUITE # 390
HARKER HEIGHTS, TX 76548
Clinical Nurse Specialist (Adult Health)
800 W CENTRAL TEXAS EXPY, SUITE 355
HARKER HEIGHTS, TX 76548
Advanced Practice Midwife
800 W CENTRAL TEXAS EXPY, SUITE 200
HARKER HEIGHTS, TX 76548
Internal Medicine (Cardiovascular Disease)
800 W CENTRAL TEXAS EXPY, STE. 355
HARKER HEIGHTS, TX 76548

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 Sanjay Pandya's NPI number?

The NPI number for Sanjay Pandya is 1639277353. It was assigned to this individual provider in the NPPES registry on September 20, 2006.

Where is Sanjay Pandya located?

Sanjay Pandya practices at 800 W Central Texas Expy Suite 355, Harker Heights, TX 76548. The listed phone number is (254) 526-2085.

What is Sanjay Pandya's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.

Is Sanjay Pandya enrolled in Medicare?

Yes. Sanjay Pandya 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 Sanjay Pandya accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 7 other insurers list Sanjay Pandya 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 Sanjay Pandya affiliated with any hospitals?

According to CMS data, Sanjay Pandya is affiliated with Adventhealth Central Texas, St David's Medical Center, Round Rock Medical Center, Cedar Park Regional Medical Center and Seton Medical Center Harker Heights.

When was this NPI record last updated?

The NPPES record for Sanjay Pandya was last updated on November 4, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.