DR. SUDHEER R KANTHARAJPUR M.D., M.H.A NPI 1730360629
Hospitalist in Huntsville, AL

Individual Male Years of Experience 23 Hospitalist PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 100 Medicare Quality Reporting

About DR. SUDHEER R KANTHARAJPUR M.D., M.H.A

Sudheer Kantharajpur is a provider established in Huntsville, Alabama and his medical specialization is Hospitalist with more than 23 years of experience. The NPI number of Sudheer Kantharajpur is 1730360629 and was assigned on November 2007. The practitioner's primary taxonomy code is 208M00000X with license number MD.29616 (AL). The provider is registered as an individual and his NPI record was last updated 12 years ago.

NPI
1730360629
Provider NameDR. SUDHEER R KANTHARAJPUR M.D., M.H.A
Provider Location Address201 SIVLEY RD SW SUITE 500 HUNTSVILLE, AL 35801
Provider Mailing Address201 SIVLEY RD SW SUITE 500 HUNTSVILLE, AL 35801
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2000
Is Sole Proprietor?No
Enumeration Date11-19-2007
Last Update Date08-31-2010

Sudheer Kantharajpur is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Sudheer Kantharajpur is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Huntsville Hospital.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 100, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance. The following quality measures were reported for this provider: care plan.

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.26 for a new patient copayment and $24.83 for an established patient copayment.



Primary Taxonomy

Taxonomy Code208M00000X
ClassificationHospitalist
TypeAllopathic & Osteopathic Physicians
License No.MD.29616
License StateAL
Taxonomy DescriptionHospitalists 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.

Business Address

DR. SUDHEER R KANTHARAJPUR M.D., M.H.A
201 SIVLEY RD SW
SUITE 500
HUNTSVILLE, AL
ZIP 35801
Phone: (256) 265-3880
Fax: (256) 265-3886

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Mailing Address

DR. SUDHEER R KANTHARAJPUR M.D., M.H.A
201 SIVLEY RD SW
SUITE 500
HUNTSVILLE, AL
ZIP 35801
Phone: (256) 265-3880
Fax: (256) 265-3886


PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID8527100783
PECOS Enrollment IDI20100126000682
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 35801 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$55.54 $170.61 $129.05
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$13.88 $42.65 $32.26
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$16.93 $139.08 $99.33
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.23 $34.77 $24.83

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

MIPS Measure Score Weight Score
Quality 40% 100
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability (PI) 25% 91.2
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities 15% 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost 20% N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
MIPS Final Score - 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

Quality Reporting

The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Care Plan 100% 345
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 or provide an advance care plan

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Sudheer Kantharajpur is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
HUNTSVILLE HOSPITAL101 SIVLEY RD
HUNTSVILLE, AL 35801
(256) 265-1000Acute Care Hospitals10039

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramMDNo

Taxonomy Description: an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1730360629
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
276066064
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 6 + 0 + 6 + 6 + 0 + 6 + 4 + 24 = 61
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 61 = 99

The NPI number 1730360629 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1235122177DR. EVAN SCOTT COHEN M.D.
Individual
Thoracic Surgery (Cardiothoracic Vascular Surgery)201 SIVLEY RD SW SUITE 300
HUNTSVILLE, AL 35801
(256) 533-1077
1639162571DR. THOMAS BENTON WASHBURN JR. M.D.
Individual
Thoracic Surgery (Cardiothoracic Vascular Surgery)201 SIVLEY RD SW SUITE 300
HUNTSVILLE, AL 35801
(256) 533-1077
1619960549DR. RICHARD LLOYD CLAY M.D.
Individual
Thoracic Surgery (Cardiothoracic Vascular Surgery)201 SIVLEY RD SW SUITE 300
HUNTSVILLE, AL 35801
(256) 533-1077
1336132281HUNTSVILLE CARDIOTHORACIC SURGEONS, PC
Organization
Thoracic Surgery (Cardiothoracic Vascular Surgery)201 SIVLEY RD SW SUITE 300
HUNTSVILLE, AL 35801
(256) 533-1077
1225015514DR. SHARON FOSTER GARDEPE MD
Individual
Dermatology201 SIVLEY RD SW STE 510
HUNTSVILLE, AL 35801
(256) 536-0992
1891773396HUNTSVILLE CARDIAC ANESTHESIA
Organization
Anesthesiology201 SIVLEY RD SW SUITE 300
HUNTSVILLE, AL 35801
(256) 533-1077
1649258260DR. ERIC MURRAY M.D.
Individual
Anesthesiology201 SIVLEY RD SW SUITE 300
HUNTSVILLE, AL 35801
(256) 533-1077
1437117603DR. MARCO CIOPPI MD
Individual
Surgery (Vascular Surgery)201 SIVLEY RD SW STE 305
HUNTSVILLE, AL 35801
(256) 536-9000
1790734051DR. RICK MICHIEL ROBERTS M.D.
Individual
Surgery (Vascular Surgery)201 SIVLEY RD SW SUITE 305
HUNTSVILLE, AL 35801
(256) 536-9000
1104876770DR. JAMES ROBERT LANCASTER M.D.
Individual
Surgery201 SIVLEY RD SW SUITE 320
HUNTSVILLE, AL 35801
(256) 536-7840
1184675118DR. STEVEN COWART M.D.
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)201 SIVLEY RD SW SUITE 450
HUNTSVILLE, AL 35801
(256) 551-4505
1902832447VASCULAR SURGERY ASSOCIATES
Organization
Preferred Provider Organization201 SIVLEY RD SW SUITE 305
HUNTSVILLE, AL 35801
(256) 536-9000
1073538732THE CENTER FOR CANCER CARE, PC
Organization
Clinic/Center (Oncology, Radiation)201 SIVLEY RD SW GROUND FLOOR
HUNTSVILLE, AL 35801
(256) 265-6590
1942228283 JESUS HERNANDEZ M.D.
Individual
Internal Medicine (Rheumatology)201 SIVLEY RD SW SUITE 600
HUNTSVILLE, AL 35801
(256) 551-6510
1932291747ENDOCRINOLOGY AND DIABETES ASSOCIATES, LLC
Organization
Internal Medicine (Endocrinology, Diabetes & Metabolism)201 SIVLEY RD SW SUITE 450
HUNTSVILLE, AL 35801
(256) 551-4505
1366561078 LUANN HOLLOWAY NP
Individual
Nurse Practitioner201 SIVLEY RD SW SUITE GROUND 2 BLACKWELL MEDICAL TOWER
HUNTSVILLE, AL 35801
(256) 265-6500
1891907515DR. YI JIA M.D.
Individual
Internal Medicine201 SIVLEY RD SW SUITE 500
HUNTSVILLE, AL 35801
(256) 265-3883
1700083482 VARUN RAMESH PUDUCHERI MD
Individual
Internal Medicine201 SIVLEY RD SW SUITE GROUND 2 BLACKWELL MEDICAL TOWER
HUNTSVILLE, AL 35801
(256) 265-6500
1497085013MRS. DIANE LOUISE BAREFIELD CRNP
Individual
Nurse Practitioner (Family)201 SIVLEY RD SW SUITE 30
HUNTSVILLE, AL 35801
(256) 265-6854
1801117262ALABAMA CENTER FOR INFECTIOUS DISEASE
Organization
Internal Medicine (Infectious Disease)201 SIVLEY RD SW SUITE 540
HUNTSVILLE, AL 35801
(256) 265-1902

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Dr. Sudheer R Kantharajpur M.d., M.h.a is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.