DR. SUJAN PATHAK MD
NPI 1689864449
Internal Medicine - Nephrology in Rapid City, SD

Active since July 27, 2007PECOS EnrolledAccepts Medicare Assignment
640 FLORMANN ST, RAPID CITY, SD 57701(605) 718-3300(605) 718-3426 Get Directions Write a Review

NPPES record last updated: February 6, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Sujan Pathak Md NPPES

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

DR. SUJAN PATHAK MD (NPI 1689864449) is an individual nephrology provider in Rapid City, South Dakota, licensed in South Dakota (8454) and active in the NPI registry since July 2007. He is enrolled in Medicare PECOS, is affiliated with Integris Baptist Medical Center, Inc, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1689864449
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameDR. SUJAN PATHAKCredential: MD
Location Address640 FLORMANN STRapid City, SD 57701-4679
Mailing Address353 Fairmont Blvd, Atten Medical Staff ServicesRapid City, SD 57701-6000
Fax(605) 718-3426
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateJuly 27, 2007
Last NPPES UpdateFebruary 6, 2013
NPI 1689864449 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License Licensed in SD · 8454
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.
640 FLORMANN ST, Rapid City, SD 57701

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. Sujan Pathak 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 ID7214082098
PECOS Enrollment IDI20160429000379
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 15

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.

Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes 99458
This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.
959 services135 patients
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457
This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.
622 services142 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.
534 services347 patients
Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454
This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.
434 services120 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.
386 services128 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.
265 services90 patients

Hospital Affiliations CMS Care Compare 5

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

Integris Baptist Medical Center, Inc

Acute Care Hospitals · Oklahoma City, OK
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number370028
Location3300 Northwest ExpresswayOklahoma City, OK 73112 · Oklahoma County
Emergency services Birthing friendly

Stillwater Medical Center

Acute Care Hospitals · Stillwater, OK
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number370049
Location1323 West 6th StreetStillwater, OK 74076 · Payne County
Emergency services Birthing friendly

Integris Southwest Medical Center

Acute Care Hospitals · Oklahoma City, OK
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number370106
Location4401 South Western AvenueOklahoma City, OK 73109 · Oklahoma County
Emergency services Birthing friendly

Integris Canadian Valley Hospital

Acute Care Hospitals · Yukon, OK
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number370211
Location1201 Health Center ParkwayYukon, OK 73099 · Canadian County
Emergency services Birthing friendly

Integris Health Edmond Hospital

Acute Care Hospitals · Edmond, OK
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number370236
Location4801 Integris ParkwayEdmond, OK 73034 · Oklahoma County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 57701 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
$126.78 typical visit price
range $55.52 – $167.23
Typical copayment $31.69 (range $13.88 – $41.80)
Most-billed visit code 99204
Established Patient
$97.88 typical visit price
range $18.08 – $137.08
Typical copayment $24.47 (range $4.52 – $34.27)
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

Clinical Information Reconciliation
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation.
97%370 patients4/55-star benchmark: 100%
Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
84%32 patients4/55-star benchmark: 95%
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.
76%1,541 patients2/55-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%404 patients4/55-star benchmark: 100%
Patient-Generated Health Data
Patient-generated health data or data from a non-clinical setting is incorporated into the certified EHR technology for at least one unique patient seen by the MIPS eligible clinician during the performance period.
6%275 patients
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…
99%275 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
78%265 patients4/55-star benchmark: 90%
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…
99%444 patients5/55-star benchmark: 97%
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: 99% · 296 patients
Patients tobacco: 99% · 296 patients
96%25 patients4/55-star benchmark: 98%
Provide Patient Access
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…
98%275 patients4/55-star benchmark: 100%
Request/Accept Summary of Care
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician receives or retrieves and incorporates into the patient's record an…
4%514 patients1/55-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 certified EHR technology to the patient (or the patient-authorized representative), or in…
93%275 patients5/55-star benchmark: 75%
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% · 265 patients
1%265 patients4/55-star benchmark: 100%
View, Download and Transmit (VDT)
During the performance period, at least one unique patient (or patient-authorized representatives) seen by the MIPS eligible clinician actively engages with the EHR made accessible by the MIPS eligible clinician.
6%275 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 20

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

Nurse Practitioner (Family)
640 FLORMANN ST
RAPID CITY, SD 57701
Family Medicine
640 FLORMANN ST
RAPID CITY, SD 57701
Internal Medicine
640 FLORMANN ST
RAPID CITY, SD 57701
640 FLORMANN ST
RAPID CITY, SD 57701
Physician Assistant
640 FLORMANN ST
RAPID CITY, SD 57701
Nurse Practitioner
640 FLORMANN ST
RAPID CITY, SD 57701
Family Medicine
640 FLORMANN ST
RAPID CITY, SD 57701
Internal Medicine (Endocrinology, Diabetes & Metabolism)
640 FLORMANN ST
RAPID CITY, SD 57701

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 Sujan Pathak's NPI number?

The NPI number for Sujan Pathak is 1689864449. It was assigned to this individual provider in the NPPES registry on July 27, 2007.

Where is Sujan Pathak located?

Sujan Pathak practices at 640 Flormann St, Rapid City, SD 57701. The listed phone number is (605) 718-3300.

What is Sujan Pathak's specialty?

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

Is Sujan Pathak enrolled in Medicare?

Yes. Sujan Pathak 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 Sujan Pathak accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 5 other insurers list Sujan Pathak 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 Sujan Pathak affiliated with any hospitals?

According to CMS data, Sujan Pathak is affiliated with Integris Baptist Medical Center, Inc, Stillwater Medical Center, Integris Southwest Medical Center, Integris Canadian Valley Hospital and Integris Health Edmond Hospital.

When was this NPI record last updated?

The NPPES record for Sujan Pathak was last updated on February 6, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.