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PRAGATI BANDA
NPI 1649567298
Hospitalist in Berkeley Heights, NJ

Active since July 05, 2011PECOS EnrolledAccepts Medicare Assignment
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922(908) 273-4300 Get Directions Write a Review

NPPES record last updated: May 19, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 19, 2022, Jul 30, 2021 (2 updates tracked since 2021).

About Pragati Banda NPPES

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

PRAGATI BANDA (NPI 1649567298) is an individual hospitalist provider in Berkeley Heights, New Jersey, licensed in New Jersey (25MA08987400) and active in the NPI registry since July 2011. She is enrolled in Medicare PECOS, is affiliated with St David's Medical Center, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1649567298
Entity TypeIndividualFemale
Primary Taxonomy208M00000X
Provider Legal NamePRAGATI BANDA
Location Address1 DIAMOND HILL RDBerkeley Heights, NJ 07922-2104
Mailing Address7000 N Mopac Expy Ste 420Austin, TX 78731-3055 · (856) 298-0591
Phone(908) 273-4300
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateJuly 5, 2011
Last NPPES UpdateMay 19, 20222 updates tracked since enumeration
NPPES CertifiedMay 19, 2022
✔ NPI 1649567298 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in NJ · 25MA08987400
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License P5027 (TX)
1 DIAMOND HILL RD, Berkeley Heights, NJ 07922
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Oscar Insurance Company, Sendero Health Plans, Local Nonprofit.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

Pragati Banda 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 ID4486816287
PECOS Enrollment IDI20210730001147
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 9

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 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.
289 services145 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
221 services216 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.
154 services88 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.
93 services93 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
49 services49 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
35 services35 patients

Hospital Affiliations CMS Care Compare 2

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

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

Ascension Seton Williamson

Acute Care Hospitals · Round Rock, TX
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number670041
Location201 Seton ParkwayRound Rock, TX 78664 · Williamson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07922 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
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
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.

Referred Medical Equipment & Supplies CMS DME claims 2

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
2 suppliers31 claims31 services$14.43 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
3 suppliers34 claims34 services$63.15 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.

SILPA GADIRAJU M.D.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1 DIAMOND HILL RD
BERKELEY HEIGHTS, NJ 07922
Union County (908) 273-4300
DR. JOHN H DOKKO DO
Internal Medicine (Nephrology)
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Union County (908) 273-4300
DENISE RIZZOLO PA
Physician Assistant
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Union County (908) 273-4300
MARIA F DOMINGUEZ BERMEO MD
Family Medicine
1 DIAMOND HILL RD
BERKELEY HEIGHTS, NJ 07922
Union County (908) 219-6940
DR. LAWRENCE J NASTRO MD
Internal Medicine (Infectious Disease)
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Union County (908) 273-4300
DEBRA A RYAN PT
Physical Therapist
1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
BERKELEY HEIGHTS, NJ 07922
Union County (908) 273-4300
CHRISTOPHER M BONI DO
Internal Medicine
1 DIAMOND HILL RD
BERKELEY HEIGHTS, NJ 07922
Union County (908) 277-8683
LAUREN BARON P.A.
Physician Assistant (Medical)
1 DIAMOND HILL RD
BERKELEY HEIGHTS, NJ 07922
Union County (908) 277-8880

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 Pragati Banda's NPI number?

The NPI number for Pragati Banda is 1649567298. It was assigned to this individual provider in the NPPES registry on July 5, 2011.

Where is Pragati Banda located?

Pragati Banda practices at 1 Diamond Hill Rd, Berkeley Heights, NJ 07922. The listed phone number is (908) 273-4300.

What is Pragati Banda's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Pragati Banda enrolled in Medicare?

Yes. Pragati Banda 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 Pragati Banda accept?

Health plans from Blue Cross and Blue Shield of Texas, Oscar Insurance Company and Sendero Health Plans, Local Nonprofit list Pragati Banda 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 Pragati Banda affiliated with any hospitals?

According to CMS data, Pragati Banda is affiliated with St David's Medical Center and Ascension Seton Williamson.

When was this NPI record last updated?

The NPPES record for Pragati Banda was last updated on May 19, 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.