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MADHAN MOHAN MD
NPI 1669482816
Internal Medicine in Pineville, KY

Active since August 09, 2006PECOS EnrolledAccepts Medicare Assignment
850 RIVERVIEW RD, PINEVILLE, KY 40977(606) 337-6047(606) 337-0925 Get Directions Write a Review

NPPES record last updated: April 28, 2008. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Madhan Mohan Md NPPES

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

MADHAN MOHAN MD (NPI 1669482816) is an individual internal medicine provider in Pineville, Kentucky, licensed in Kentucky (29667) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1985).

NPPES Registry Identity

NPI1669482816
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameMADHAN MOHANCredential: MD
Location Address850 RIVERVIEW RDPineville, KY 40977-1430
Mailing Address850 Riverview Rd, Po Box 308Pineville, KY 40977-1430 · (606) 337-6047 · Fax (606) 337-0925
Phone(606) 337-6047
Fax(606) 337-0925
Sole ProprietorYes
Medical School CMSOtherGraduated 1985
Enumeration DateAugust 9, 2006
Last NPPES UpdateApril 28, 2008
✔ NPI 1669482816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in KY · 29667
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.
850 RIVERVIEW RD, Pineville, KY 40977
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Other Identifiers 4

Medicaid64296676KY
Medicare PIN0384501KY
Medicare UPINF61948
Medicare PIN110155218KY

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

Madhan Mohan 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 ID8628085552
PECOS Enrollment IDI20120920000714
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

2

Medicare enrollment records show Madhan Mohan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ultacare Medical PLLC
23 mi
Family Medicine
606 N BROAD ST
New Tazewell, TN 37825
  • Reassigned Medicare billing, Tennessee enrollment
  • 84 clinicians in this Medicare group
NPI 1225141492 (423) 259-5002
Provider Partners Care Management LP
413 mi
Nurse Practitioner
8820 COLUMBIA 100 PKWY STE 430
Columbia, MD 21045
  • Reassigned Medicare billing, Tennessee enrollment
  • 25 clinicians in this Medicare group
NPI 1013348028 (443) 275-9800

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40977 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.

Reported Quality Measures

Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
32%260 patients2/55-star benchmark: 98%
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
73%260 patients3/55-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.
98%3,605 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.
65%5,245 patients1/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
11%47 patients1/55-star benchmark: 88%
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.
96%24 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.
2%532 patients1/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
38%1,281 patients2/55-star benchmark: 97%
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%532 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…
7%532 patients1/55-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+: 14% · 283 patients
26%283 patients1/55-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.
7%532 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.

Referred Medical Equipment & Supplies CMS DME claims 8

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
5 suppliers12 claims27 services$6.13 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier54 claims55 services$18.36 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
1 supplier48 claims48 services$918.10 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers16 claims16 services$8.29 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 suppliers149 claims153 services$108.08 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier19 claims20 services$27.59 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.

JAMES S. HARTLEY
Emergency Medicine
850 RIVERVIEW RD
PINEVILLE, KY 40977
Bell County (800) 291-4020
SANKAR LAKSHMAN M.D.
Radiology (Diagnostic Radiology)
850 RIVERVIEW RD
PINEVILLE, KY 40977
Bell County (276) 523-7938
PINEVILLE RADIOLOGY ASSOCIATES, PSC
Radiology (Diagnostic Radiology)
850 RIVERVIEW RD
PINEVILLE, KY 40977
Bell County (276) 523-7938
PINE MOUNTAIN CLINIC PSC
Internal Medicine
850 RIVERVIEW RD
PINEVILLE, KY 40977
Bell County (606) 337-6047
DR. J KAREN CLARK M.D.
Radiology (Diagnostic Radiology)
850 RIVERVIEW RD
PINEVILLE, KY 40977
Bell County (606) 337-3051
DR. KATHRYN LEFEVERS
Dentist
850 RIVERVIEW RD, 3RD FLOOR PCH
PINEVILLE, KY 40977
Bell County (606) 337-6297
PINEVILLE COMMUNITY HOSPITAL ASSN INC
Pharmacy (Community/Retail Pharmacy)
850 RIVERVIEW RD
PINEVILLE, KY 40977
Bell County (606) 337-4240
TENNESSEE CANCER SPECIALISTS PLLC
Internal Medicine (Hematology & Oncology)
850 RIVERVIEW RD, PINEVILLE COMMUNITY HOSPITAL
PINEVILLE, KY 40977
Bell County (865) 934-5800

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 Madhan Mohan's NPI number?

The NPI number for Madhan Mohan is 1669482816. It was assigned to this individual provider in the NPPES registry on August 9, 2006.

Where is Madhan Mohan located?

Madhan Mohan practices at 850 Riverview Rd, Pineville, KY 40977. The listed phone number is (606) 337-6047.

What is Madhan Mohan's specialty?

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

Is Madhan Mohan enrolled in Medicare?

Yes. Madhan Mohan 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 Madhan Mohan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Madhan Mohan reassigns Medicare benefits to 2 organizations: Ultacare Medical PLLC (New Tazewell, TN) and Provider Partners Care Management LP (Columbia, MD). 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 Madhan Mohan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Madhan Mohan was last updated on April 28, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.