1. Home
  2. Directory
  3. Wisconsin
  4. Madison
  5. Family Medicine
  6. NPI Profile

NILAM A RAVAL MD
NPI 1770535882
Family Medicine in Madison, WI

Active since May 17, 2006PECOS EnrolledAccepts Medicare Assignment
752 N HIGH POINT RD, MADISON, WI 53717(608) 824-4800(608) 824-4917 Get Directions Write a Review

NPPES record last updated: April 6, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 6, 2021, Nov 17, 2015 (2 updates tracked since 2015).

About Nilam A Raval Md NPPES

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

NILAM A RAVAL MD (NPI 1770535882) is an individual family medicine provider in Madison, Wisconsin, licensed in Wisconsin (48329-020) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Ssm Health St Mary's Hospital - Madison, and is a graduate of Other (1999).

NPPES Registry Identity

NPI1770535882
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameNILAM A RAVALCredential: MD
Location Address752 N HIGH POINT RDMadison, WI 53717-2236
Mailing Address752 N High Point RdMadison, WI 53717-2236 · (608) 824-4800 · Fax (608) 824-4917
Phone(608) 824-4800
Fax(608) 824-4917
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateMay 17, 2006
Last NPPES UpdateApril 6, 20212 updates tracked since enumeration
NPPES CertifiedApril 6, 2021
✔ NPI 1770535882 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WI · 48329-020
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
752 N HIGH POINT RD, Madison, WI 53717
Open in Google Maps ↗

Other Identifiers 1

Medicaid1770535882WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Nilam A Raval 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 ID648295949
PECOS Enrollment IDI20051005001201
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 6

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.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
91 services45 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.
54 services38 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.
50 services35 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
32 services32 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
16 services15 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.
13 services13 patients

Hospital Affiliations CMS Care Compare

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

Ssm Health St Mary's Hospital - Madison

Acute Care Hospitals · Madison, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520083
Location700 South Park StMadison, WI 53715 · Dane County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53717 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
66%35 patients3/55-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
95%41 patients4/55-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…
24%50 patients1/55-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
81%26 patients4/55-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.

HEATHER L MUCKLER COTA
Occupational Therapy Assistant
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4821
DR. MINDY BAUER PHARMD
Pharmacist
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4500
DAVID K FALK MD
Dermatology
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000
DAVID A SORBER MD
Internal Medicine
752 N HIGH POINT RD, DEAN MEDICAL CENTER
MADISON, WI 53717
Dane County (608) 824-4800
JULIA L. THORSEN M.D.
Allergy & Immunology
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000
SARAH A OLIVER PA-C
Physician Assistant
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000
DR. GRANT MACAULAY M.D.
Internal Medicine
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000
DR. JUI B HAKER MD
Preventive Medicine (Occupational Medicine)
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000

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 Nilam Raval's NPI number?

The NPI number for Nilam Raval is 1770535882. It was assigned to this individual provider in the NPPES registry on May 17, 2006.

Where is Nilam Raval located?

Nilam Raval practices at 752 N High Point Rd, Madison, WI 53717. The listed phone number is (608) 824-4800.

What is Nilam Raval's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Nilam Raval enrolled in Medicare?

Yes. Nilam Raval 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 Nilam Raval accept?

Health plans from Anthem Blue Cross and Blue Shield list Nilam Raval 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 Nilam Raval affiliated with any hospitals?

According to CMS data, Nilam Raval is affiliated with Ssm Health St Mary's Hospital - Madison.

When was this NPI record last updated?

The NPPES record for Nilam Raval was last updated on April 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.