DR. MANGLA S GULATI M.D. NPI 1740259274
Hospitalist in Baltimore, MD
About DR. MANGLA S GULATI M.D.
Mangla Gulati is a provider established in Baltimore, Maryland and her medical specialization is Hospitalist with more than 32 years of experience. The NPI number of this provider is 1740259274 and was assigned on March 2006. The practitioner's primary taxonomy code is 208M00000X with license number D59068 (MD). The provider is registered as an individual and her NPI record was last updated 15 years ago.
| NPI | 1740259274 |
| Provider Name | DR. MANGLA S GULATI M.D. |
| Location Address | 22 S GREENE ST BALTIMORE, MD 21201 |
| Location Phone | (410) 328-5793 |
| Mailing Address | PO BOX 64442 BALTIMORE, MD 21264 |
| Gender | Female |
| NPI Entity Type | Individual |
| Medical School Name | OTHER |
| Graduation Year | 1991 |
| Is Sole Proprietor? | No |
| Enumeration Date | 03-16-2006 |
| Last Update Date | 02-14-2008 |
Mangla Gulati 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.
Mangla Gulati 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 she has hospital affiliations with University Of Maryland Medical Center.
The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 95.17, 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 typical physician office visit costs for Medicare beneficiaries in this area are: $36.36 for a new patient copayment and $28.06 for an established patient copayment.
Primary Taxonomy
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.
| Taxonomy Code | 208M00000X |
| Classification | Hospitalist |
| Type | Allopathic & Osteopathic Physicians |
| License No. | D59068 |
| License State | MD |
| Taxonomy Description | Hospitalists 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. |
Accepted Insurance
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
- Blue Cross Blue Shield
- Medicaid
- Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Business Address
22 S GREENE ST
BALTIMORE, MD
ZIP 21201
Phone: (410) 328-5793
Fax: (410) 328-0248
Mailing Address
PO BOX 64442
BALTIMORE, MD
ZIP 21264
Phone: (410) 328-5793
Fax: (410) 328-0248
Location Map
PECOS Enrollment and Medicare Participation Status
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 ID | 4385539212 |
| PECOS Enrollment ID | I20040218001007 |
| 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 Imaging | Yes |
| Eligible order / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | Yes |
| Eligible order / refer Power Mobility Devices | Yes |
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 21201 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 |
| $63.64 | $191.95 | $145.45 |
| Minimum New Patient Copayment | Maximum New Patient Copayment | Typical New Patient Copayment |
| $15.91 | $47.98 | $36.36 |
| 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 |
| $19.91 | $156.57 | $112.24 |
| Minimum Established Patient Copayment | Maximum Established Patient Copayment | Typical Established Patient Copayment |
| $4.97 | $39.14 | $28.06 |
* 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% | 91.23 | |
|
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. |
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| Promoting Interoperability (PI) | 25% | 100 | |
|
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. |
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| 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. |
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| 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. |
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| MIPS Final Score | - | 95.17 | |
| 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. | |||
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. Mangla Gulati is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | CMS Certification Number (CCN) | Overall Rating |
|---|---|---|---|---|---|
| UNIVERSITY OF MARYLAND MEDICAL CENTER | 22 SOUTH GREENE STREET BALTIMORE, MD 21201 | (410) 328-8667 | Acute Care Hospitals | 210002 |
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 617296-01 | OTHER (01) | MD | BLUE CROSS/BLUE SHIELD |
| H402 | MEDICARE PIN (08) | MD | |
| 1740259274 | MEDICAID (05) | DE | |
| H71830 | MEDICARE UPIN (02) | ||
| P00218940 | MEDICARE PIN (08) | MD |
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. | |||||||||
| 1 | 7 | 4 | 0 | 2 | 5 | 9 | 2 | 7 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 8 | 0 | 4 | 5 | 18 | 2 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 8 + 0 + 4 + 5 + 1 + 8 + 2 + 1 + 4 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1740259274 is valid because the calculated check digit 4 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 |
|---|---|---|---|
| 1750383063 | MS. MALINDA DANIEL DUKE CPNP, CDE Individual | Nurse Practitioner (Pediatrics) | 22 S GREENE ST RM N6W84 BALTIMORE, MD 21201 (410) 328-3410 |
| 1700881802 | DR. MARIA BAER MD Individual | Internal Medicine (Hematology & Oncology) | 22 S GREENE ST BALTIMORE, MD 21201 (410) 328-8708 |
| 1982604773 | MICHELLE DUELL CRNA Individual | Specialist | 22 S GREENE ST BALTIMORE, MD 21201 (410) 328-6704 |
| 1003817131 | DR. LISA MANUELA MARTINEZ M.D. Individual | Internal Medicine | 22 S GREENE ST BALTIMORE, MD 21201 (410) 328-9595 |
| 1164416400 | DR. KIRSTEN ELLIZABETH LYKE M.D. Individual | Internal Medicine (Infectious Disease) | 22 S GREENE ST BALTIMORE, MD 21201 (410) 328-5793 |
| 1225023278 | MR. CHRISTOPHER OUDEKERK CRNA Individual | Nurse Anesthetist, Certified Registered | 22 S GREENE ST BALTIMORE, MD 21201 (410) 328-6704 |
| 1942296124 | DR. MARCIA A MCAVOY M.D. Individual | Radiology (Diagnostic Radiology) | 22 S GREENE ST DEPT. OF RADIOLOGY BALTIMORE, MD 21201 (410) 328-3477 |
| 1649266610 | DR. GEORGE W GROSS MD Individual | Radiology (Diagnostic Radiology) | 22 S GREENE ST ROOM N2E23 BALTIMORE, MD 21201 (410) 328-5656 |
| 1568459733 | MRS. DARBI NICHOLE ROBINSON CRNP Individual | Nurse Practitioner | 22 S GREENE ST NEONATOLOGY DEPARTMENT BALTIMORE, MD 21201 (410) 328-6717 |
| 1376534222 | DR. PETR FRANTISEK HAUSNER MD Individual | Internal Medicine (Medical Oncology) | 22 S GREENE ST BALTIMORE, MD 21201 (410) 328-2567 |
| 1427039940 | ROGER DAVID BAXTER CRNA Individual | Nurse Anesthetist, Certified Registered | 22 S GREENE ST BALTIMORE, MD 21201 (410) 328-6704 |
| 1154303998 | DR. RAYMOND FANG M.D. Individual | Surgery (Surgical Critical Care) | 22 S GREENE ST BALTIMORE, MD 21201 (410) 328-6704 |
| 1497730592 | MAYURIKA GHOSH MD Individual | Internal Medicine (Infectious Disease) | 22 S GREENE ST BALTIMORE, MD 21201 (410) 328-2463 |
| 1790763993 | DR. THOMAS M SCALEA M.D. Individual | Surgery (Trauma Surgery) | 22 S GREENE ST BALTIMORE, MD 21201 (410) 328-6566 |
| 1649250622 | DR. KENT EDWARD KESTER M.D. Individual | Internal Medicine (Infectious Disease) | 22 S GREENE ST BALTIMORE, MD 21201 (410) 328-6704 |
| 1518939925 | DR. WILLIAM C CHIU M.D. Individual | Surgery (Trauma Surgery) | 22 S GREENE ST BALTIMORE, MD 21201 (410) 328-6566 |
| 1417921735 | DR. ELLIOT MICHAEL JESSIE M.D. Individual | Surgery (Trauma Surgery) | 22 S GREENE ST BALTIMORE, MD 21201 (410) 328-6704 |
| 1720047129 | HEATHER D MANNUEL MD Individual | Internal Medicine (Medical Oncology) | 22 S GREENE ST BALTIMORE, MD 21201 (410) 328-2567 |
| 1619937539 | DR. RAJABRATA SARKAR M.D., PH.D. Individual | Surgery (Vascular Surgery) | 22 S GREENE ST S10B00 BALTIMORE, MD 21201 (410) 328-5840 |
| 1003877093 | DR. CAROL OVERTON TACKET M.D. Individual | Internal Medicine (Infectious Disease) | 22 S GREENE ST BALTIMORE, MD 21201 (410) 328-5793 |
Frequently Asked Questions
What is Dr. Mangla Gulati M.D. NPI number?
The NPI number assigned to this healthcare provider is 1740259274, registered as an "individual" on March 16, 2006
Where is Dr. Mangla Gulati M.D. located?
The provider is located at 22 S Greene St Baltimore, Md 21201 and the phone number is (410) 328-5793
Which is Dr. Mangla Gulati M.D. specialty?
The provider's speciality is Hospitalist
How many years of experience does Dr. Mangla Gulati M.D. have?
The provider has more than 32 years of experience.
What insurance does Dr. Mangla Gulati M.D. accept?
The provider might be accepting Blue Cross Blue Shield, Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Is Dr. Mangla Gulati M.D. registered in PECOS?
Yes, as of May 11, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary 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.
What are Dr. Mangla Gulati M.D. Quality Ratings?
The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.
How much is a visit to Dr. Mangla Gulati M.D.?
Medicare beneficiaries should expect a typical cost of $145.45 with an average copayment of $36.36 for new patient appointments. Established patients should expect a typical charge of $112.24 and an average copayment of 28.06. Please review your insurance plan or contact the provider directly to determine your specific costs.
Is Dr. Mangla Gulati M.D. affiliated to any hospitals?
The practitioner is affiliated to the following hospitals: UNIVERSITY OF MARYLAND MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
How do I update my NPI information?
The NPI record of Dr. Mangla Gulati M.D. was last updated on March 16, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
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