DR. RISHI RAJ MD
NPI 1770965683
Internal Medicine - Endocrinology, Diabetes & Metabolism in Pikeville, KY

Q: What is Rishi Raj's NPI number?

The NPI number for Rishi Raj is 1770965683. It was assigned to this individual provider in the NPPES registry on June 26, 2015.

Q: What is Rishi Raj's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Q: When was this NPI record last updated?

The NPPES record for Rishi Raj was last updated on December 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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 June 26, 2015PECOS EnrolledAccepts Medicare Assignment

86.86/100

CMS Quality Rating

911 BYPASS RD BLDG A, PIKEVILLE, KY 41501(606) 430-2208(606) 218-7508 Get Directions Write a Review

NPPES record last updated: December 11, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Dec 11, 2024, Jul 20, 2022, Apr 5, 2021 and 2 more (5 updates tracked since 2018).

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About Dr. Rishi Raj Md NPPES

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

DR. RISHI RAJ MD (NPI 1770965683) is an individual endocrinology, diabetes & metabolism provider in Pikeville, Kentucky, licensed in Kentucky (51169) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS, is affiliated with Henry Ford Allegiance Health, and maintains a secondary practice location in Jackson.

NPPES Registry Identity

NPI1770965683

Entity TypeIndividualMale

Primary Taxonomy207RE0101X

Provider Legal NameDR. RISHI RAJCredential: MD

Location Address911 BYPASS RD BLDG APikeville, KY 41501-1689

Mailing AddressPo Box 432Pikeville, KY 41502-0432 · (606) 430-2208 · Fax (606) 218-7508

Phone(606) 430-2208

Fax(606) 218-7508

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateJune 26, 2015

Last NPPES UpdateDecember 11, 20245 updates tracked since enumeration

NPPES CertifiedDecember 11, 2024

✔ NPI 1770965683 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians

Taxonomy Code207RE0101X

Licenses✔ Licensed in KY · 51169✔ Licensed in MI · 4301513256

Definition

An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

911 BYPASS RD BLDG A, Pikeville, KY 41501

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Secondary Practice Location 1

Location 13333 Spring Arbor Rd Ste 200Jackson, MI 49203-8622 · Phone (517) 205-1000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, CareSource and more.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. Rishi Raj 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 ID749538692

PECOS Enrollment IDI20241216003344

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 5

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.

178 services104 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.

61 services48 patients

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251

This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.

42 services30 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.

36 services36 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.

27 services27 patients

Hospital Affiliations CMS Care Compare

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

Henry Ford Allegiance Health

Acute Care Hospitals · Jackson, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number230092

Location205 N East AveJackson, MI 49201 · Jackson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41501 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

$122.77 typical visit price

range $52.76 – $162.27

Typical copayment $30.69 (range $13.19 – $40.56)

Most-billed visit code 99204

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

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.

86.86/100

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

Scored as part of a group practice

Quality

72.39

Promoting Interoperability

100

Improvement Activities

Cost

70.65

Referred Medical Equipment & Supplies CMS DME claims 3

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

External ambulatory infusion pump, insulin E0784

DME-Other DME · category DE017N

2 suppliers20 claims20 services$314.85 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

11 suppliers220 claims221 services$178.22 avg. paid by Medicare

Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system K0554

DME-Other DME · category DE017N

5 suppliers11 claims11 services$199.91 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

MRS. WHITNEY P. BURTON PA-C

Physician Assistant