DR. SANJAY M LALL M.D.
NPI 1699779488
Internal Medicine - Cardiovascular Disease in Gainesville, GA

Active since June 09, 2005PECOS EnrolledAccepts Medicare Assignment
78.35/100
CMS Quality Rating
200 S ENOTA DR NE STE 100, GAINESVILLE, GA 30501(770) 534-2020 Get Directions Write a Review

NPPES record last updated: October 18, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 18, 2023, Mar 7, 2023, Mar 17, 2017 (3 updates tracked since 2017).

About Dr. Sanjay M Lall M.d. NPPES

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

DR. SANJAY M LALL M.D. (NPI 1699779488) is an individual cardiovascular disease provider in Gainesville, Georgia, licensed in Georgia (057878) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with Northeast Georgia Medical Center, Inc, and is a graduate of Clvlnd Clinic Lerner College Of Med Of Case Wstn Rsv University (1997).

NPPES Registry Identity

NPI1699779488
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameDR. SANJAY M LALLCredential: M.D.
Location Address200 S ENOTA DR NE STE 100Gainesville, GA 30501-3466
Mailing AddressPo Box 742616Atlanta, GA 30374-2616 · (770) 219-8420
Sole ProprietorNo
Medical School CMSClvlnd Clinic Lerner College Of Med Of Case Wstn Rsv UniversityGraduated 1997
Enumeration DateJune 9, 2005
Last NPPES UpdateOctober 18, 20233 updates tracked since enumeration
NPPES CertifiedOctober 18, 2023
NPI 1699779488 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License Licensed in GA · 057878
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
200 S ENOTA DR NE STE 100, Gainesville, GA 30501

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 M Lall 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 ID5991754657
PECOS Enrollment IDI20060801000294
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 31

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.

Injection, inclisiran, 1 mg J1306
Inclisiran is an injection administered to lower cholesterol levels. It works by blocking the production of LDL (bad cholesterol) in your liver. This medicine is often used when diet changes and other medications have not been effective.
3,692 services13 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.
465 services456 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
422 services365 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.
262 services204 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.
196 services125 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.
168 services127 patients

Hospital Affiliations CMS Care Compare 5

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

Northeast Georgia Medical Center, Inc

Acute Care Hospitals · Gainesville, GA
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number110029
Location743 Spring StreetGainesville, GA 30501 · Hall County
Emergency services Birthing friendly

Northeast Georgia Medical Center Habersham

Acute Care Hospitals · Demorest, GA
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110041
Location541 Historic Highway 441-NorthDemorest, GA 30535 · Habersham County
Emergency services Birthing friendly

Ngmc Barrow, LLC

Acute Care Hospitals · Winder, GA
OwnershipProprietary
CMS Certification Number110045
Location316 North Broad StreetWinder, GA 30680 · Barrow County
Emergency services

Union General Hospital

Acute Care Hospitals · Blairsville, GA
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110051
Location35 Hospital RoadBlairsville, GA 30512 · Union County
Emergency services Birthing friendly

Northeast Georgia Medical Center Lumpkin

Acute Care Hospitals · Dahlonega, GA
OwnershipVoluntary non-profit - Other
CMS Certification Number110237
Location495 Highway 400 NorthDahlonega, GA 30533 · Lumpkin County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30501 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
Most-billed visit code 99213
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.

78.35/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality76.17
Promoting Interoperability89
Improvement Activities40
Cost60.82

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
5%489 patients1/55-star benchmark: 100%
Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation
Percentage of patients aged 18 years and older with a diagnosis of COPD who had spirometry results documented
21%24 patients1/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
8%299 patients1/55-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
18%491 patients1/55-star benchmark: 100%
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…
27%522 patients2/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
7%216 patients1/55-star benchmark: 98%
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.

Internal Medicine (Advanced Heart Failure and Transplant Cardiology)
200 S ENOTA DR NE STE 100
GAINESVILLE, GA 30501
Nurse Practitioner (Family)
200 S ENOTA DR NE STE 100
GAINESVILLE, GA 30501
Physician Assistant
200 S ENOTA DR NE STE 100
GAINESVILLE, GA 30501
Nurse Practitioner (Adult Health)
200 S ENOTA DR NE STE 100
GAINESVILLE, GA 30501
Nurse Practitioner (Family)
200 S ENOTA DR NE STE 100
GAINESVILLE, GA 30501
Physician Assistant
200 S ENOTA DR NE STE 100
GAINESVILLE, GA 30501
Internal Medicine (Cardiovascular Disease)
200 S ENOTA DR NE STE 100
GAINESVILLE, GA 30501
Internal Medicine (Cardiovascular Disease)
200 S ENOTA DR NE STE 100
GAINESVILLE, GA 30501

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 Lall's NPI number?

The NPI number for Sanjay Lall is 1699779488. It was assigned to this individual provider in the NPPES registry on June 9, 2005.

Where is Sanjay Lall located?

Sanjay Lall practices at 200 S Enota Dr NE Ste 100, Gainesville, GA 30501. The listed phone number is (770) 534-2020.

What is Sanjay Lall's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Sanjay Lall enrolled in Medicare?

Yes. Sanjay Lall 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 Lall accept?

Health plans from Alliant Health Plans, Inc. list Sanjay Lall 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 Lall affiliated with any hospitals?

According to CMS data, Sanjay Lall is affiliated with Northeast Georgia Medical Center, Inc, Northeast Georgia Medical Center Habersham, Ngmc Barrow, LLC, Union General Hospital and Northeast Georgia Medical Center Lumpkin.

When was this NPI record last updated?

The NPPES record for Sanjay Lall was last updated on October 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.