PRIYANKA PATHANIA M.D.
NPI 1720242340
Internal Medicine - Pulmonary Disease in Tulsa, OK

Q: What is Priyanka Pathania's NPI number?

The NPI number for Priyanka Pathania is 1720242340. It was assigned to this individual provider in the NPPES registry on July 13, 2008.

Q: What is Priyanka Pathania's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Priyanka Pathania was last updated on July 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.

Active since July 13, 2008PECOS EnrolledAccepts Medicare Assignment

91.24/100

CMS Quality Rating

1725 E 19TH ST STE 200, TULSA, OK 74104(918) 748-8381 Get Directions Write a Review

NPPES record last updated: July 17, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 17, 2026, Jan 18, 2022 (2 updates tracked since 2022).

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About Priyanka Pathania M.d. NPPES

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

PRIYANKA PATHANIA M.D. (NPI 1720242340) is an individual pulmonary disease provider in Tulsa, Oklahoma, licensed in Oklahoma (31134) and active in the NPI registry since July 2008. She is enrolled in Medicare PECOS, is affiliated with Ascension St John Jane Phillips, and maintains a secondary practice location in Hartford.

NPPES Registry Identity

NPI1720242340

Entity TypeIndividualFemale

Primary Taxonomy207RP1001X

Provider Legal NamePRIYANKA PATHANIACredential: M.D.

Location Address1725 E 19TH ST STE 200Tulsa, OK 74104-5419

Mailing Address1725 E 19th St Ste 200Tulsa, OK 74104-5419 · (918) 748-8381

Phone(918) 748-8381

Sole ProprietorNo

Medical School CMSOtherGraduated 2006

Enumeration DateJuly 13, 2008

Last NPPES UpdateJuly 17, 20262 updates tracked since enumeration

NPPES CertifiedJuly 17, 2026

✔ NPI 1720242340 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in OK · 31134

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1725 E 19TH ST STE 200, Tulsa, OK 74104

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Secondary Practice Location 1

Location 1250 Main St Apt 236Hartford, CT 06106-1869 · Phone (918) 748-8381

Other Identifiers 1

Medicaid201036890AOK

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma, CommunityCare.Insurance ›

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

Priyanka Pathania 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 ID1759774359

PECOS Enrollment IDI20220203000189

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 Reassignment

Medicare enrollment records show Priyanka Pathania reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

St. John Physicians, Inc.

0.1 mi

Internal Medicine

1923 S UTICA AVE, DAVIS TOWER 200
Tulsa, OK 74104

Reassigned Medicare billing, Oklahoma enrollment
820 clinicians in this Medicare group

NPI 1336194406 (918) 744-2345

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

Areas of Expertise CMS Part B claims 22

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 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.

285 services196 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.

115 services115 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

107 services106 patients

Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811

A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.

98 services89 patients

Sleep study in sleep lab (6 years or older) 95810

A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.

80 services76 patients

Test to determine lung volumes using gas dilution or washout 94727

This test measures lung volumes by either diluting or washing out a known amount of gas in your lungs. You'll breathe in a harmless gas, then exhale. The exhaled air is analyzed to assess your lung capacity and function.

64 services64 patients

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.

60 services49 patients

Test to measure expiratory airflow and volume 94010

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

57 services57 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

57 services57 patients

Sleep study including heart rate, breathing, airflow, and effort 95806

A sleep study monitors your heart rate, breathing patterns, airflow, and physical effort while you sleep. It helps identify sleep disorders by tracking your sleep stages and cycles. This data aids doctors in diagnosing and treating sleep-related issues.

48 services47 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

47 services47 patients

Test to examine how well the lungs exchange gases 94729

47 services47 patients

Test to determine lung volumes using sensors 94726

43 services43 patients

Test to measure expiratory airflow and volume 94010

42 services42 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

35 services35 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

32 services29 patients

Evaluation of use of breathing device 94664

The evaluation of a breathing device involves checking how effectively you're using it to manage your respiratory condition. It assesses the device's fit, your comfort, and your technique to ensure optimal results.

31 services30 patients

Telephone medical discussion with physician, 5-10 minutes 99441

A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.

13 services12 patients

Irrigation and suction of lung airways to obtain cells using an endoscope 31624

This is a procedure where a thin, flexible tube called an endoscope is inserted through your mouth into the lungs. A small amount of saline is then introduced to wash the airways. The fluid, along with cells from the lung, is suctioned back for analysis.

12 services12 patients

Computer-assisted image-guided navigation of lung airways using an endoscope 31627

This procedure involves the use of a special camera, called an endoscope, and computer technology to create real-time images of your lung airways. This helps doctors navigate through your lungs accurately, aiding in diagnosis or treatment.

11 services11 patients

Biopsy of lobe of lung using an endoscope, 1 lobe 31628

A lung biopsy is a procedure where a small piece of lung tissue is taken for testing. An endoscope, a flexible tube with a light and camera, is used. It's inserted through the mouth or nose, down the windpipe, and into one lobe of the lung.

11 services11 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Ascension St John Jane Phillips

Acute Care Hospitals · Bartlesville, OK

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number370018

Location3500 East Frank Phillips BoulevardBartlesville, OK 74006 · Washington County

Emergency services Birthing friendly

Ascension St John Medical Center

Acute Care Hospitals · Tulsa, OK

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number370114

Location1923 South Utica AvenueTulsa, OK 74104 · Tulsa County

Emergency services Birthing friendly

St John Owasso

Acute Care Hospitals · Owasso, OK

OwnershipVoluntary non-profit - Private

CMS Certification Number370227

Location12451 East 100th Street NorthOwasso, OK 74055 · Tulsa County

Emergency services Birthing friendly

Ascension St John Broken Arrow

Acute Care Hospitals · Broken Arrow, OK

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number370235

Location1000 West Boise CircleBroken Arrow, OK 74012 · Tulsa County

Emergency services

Ascension St John Sapulpa

Critical Access Hospitals · Sapulpa, OK

OwnershipVoluntary non-profit - Private

CMS Certification Number371312

Location1004 East BryanSapulpa, OK 74066 · Creek County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74104 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

$123.06 typical visit price

range $53.00 – $162.61

Typical copayment $30.76 (range $13.25 – $40.65)

Most-billed visit code 99204

Established Patient

$94.27 typical visit price

range $16.68 – $132.40

Typical copayment $23.56 (range $4.17 – $33.10)

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.

91.24/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

74.13

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 13

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

Tubing with integrated heating element for use with positive airway pressure device A4604