DR. RAJNISH VERMA M.D
NPI 1790985810
Internal Medicine in Durham, NC

NPI Status: Active since July 18, 2007

Contact Information

2301 ERWIN RD
DURHAM, NC
ZIP 27705
Phone: (919) 684-8964
Fax: (919) 684-5325

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  • Individual
  • Male
  • Years of Experience 25
  • Internal Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About RAJNISH VERMA

This page provides the complete NPI Profile along with additional information for Rajnish Verma, an internist established in Durham, North Carolina with a medical specialization in Internal Medicine and more than 25 years of experience. The healthcare provider is registered in the NPI registry with number 1790985810 assigned on July 2007. The practitioner's primary taxonomy code is 207R00000X with license number 2020-04362 (NC). The provider is registered as an individual and his NPI record was last updated 4 years ago.

NPI
1790985810
Provider Name
DR. RAJNISH VERMA M.D
Gender
Male
Entity Type
Individual
Location Address
2301 ERWIN RD DURHAM, NC 27705
Location Phone
(919) 684-8964
Location Fax
(919) 684-5325
Mailing Address
2301 ERWIN RD DURHAM, NC 27705
Mailing Phone
(919) 684-8964
Mailing Fax
(919) 684-5325
Medical School Name
OTHER
Graduation Year
2001
Is Sole Proprietor?
No
Enumeration Date
07-18-2007
Last Update Date
04-07-2021
Code Navigator

An internist like Rajnish Verma is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
2020-04362
License State
NC
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207R00000XAllopathic & Osteopathic Physicians

Internal Medicine

49826020 (WI)
2208M00000XAllopathic & Osteopathic Physicians

Hospitalist

49826 (WI)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Connect Bronze 5500 Indiv Med Deductible - HMO
  • Connect Bronze 6500 Indiv Med Deductible - HMO
  • Connect Bronze CMS Standard - HMO
  • Connect Gold CMS Standard - HMO
  • Connect Silver 3500 Indiv Med Deductible - HMO
  • Connect Silver 4400 Indiv Med Deductible - HMO
  • Connect Silver CMS Standard - HMO
  • Engage by Medica Bronze HSA - EPO
  • Engage by Medica Bronze Share - EPO
  • Engage by Medica Expanded Bronze Standard - EPO
  • Engage by Medica Gold $0 Copay PCP Visits - EPO
  • Engage by Medica Gold Share - EPO
  • Engage by Medica Gold Standard - EPO
  • Engage by Medica Silver $0 Copay PCP Visits - EPO
  • Engage by Medica Silver Share - EPO
  • Engage by Medica Silver Standard - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Rajnish Verma is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Rajnish Verma 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.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 4385717446

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20220623003445

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • 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 to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $31.25 for a new patient copayment and $23.98 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 27705 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $125.01
  • Minimum New Patient Price $54.12
  • Maximum New Patient Price $165.09
  • Average New Patient Copayment $31.25
  • Minimum New Patient Copayment $13.53
  • Maximum New Patient Copayment $41.27

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $95.94
  • Minimum Established Patient Price $17.21
  • Maximum Established Patient Price $134.61
  • Average Established Patient Copayment $23.98
  • Minimum Established Patient Copayment $4.3
  • Maximum Established Patient Copayment $33.65

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

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical 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. Rajnish Verma is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
DUKE UNIVERSITY HOSPITAL2100 ERWIN RD
DURHAM, NC 27705
(919) 684-8111Acute Care Hospitals

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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.
1790985810
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
271801881082
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 8 + 0 + 1 + 8 + 8 + 1 + 0 + 8 + 2 + 24 = 70
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1790985810 is valid because the calculated check digit 0 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.

DR. JAY JEFFREY MEYER M.D.

Ophthalmology

2301 ERWIN RD
DURHAM, NC
ZIP 27705

(919) 684-8111

DR. GEORGE RAYBURN CHEELY JR. M.D.

Student in an Organized Health Care Education/Training Program

2301 ERWIN RD
DUKE UNIVERSITY HOSPITAL, HOSPITAL MED BOX 100800, DUMC
DURHAM, NC
ZIP 27705

(215) 805-2142

DR. ERIC CHIANE CHU M.D.

Internal Medicine

2301 ERWIN RD
DURHAM, NC
ZIP 27705

(919) 684-8111

MR. DALE ORITSEWEYINMI OKORODUDU

Student in an Organized Health Care Education/Training Program

2301 ERWIN RD
DUKE MEDICAL RESIDENTS OFFICE
DURHAM, NC
ZIP 27705

(919) 684-5369

MR. BRYAN HAMPTON PA-C

Physician Assistant

2301 ERWIN RD
DUKE NORTH 3200
DURHAM, NC
ZIP 27705

(919) 681-3241

SAHAR KOUBAR MD

Internal Medicine

2301 ERWIN RD
RM 8254DN
DURHAM, NC
ZIP 27705

(919) 970-1637

STEPHANIE BUCK ANP

Nurse Practitioner

2301 ERWIN RD
DURHAM, NC
ZIP 27705

(919) 681-2425

KRISTI LYNN SEWARD PA-C

Physician Assistant

2301 ERWIN RD
DURHAM, NC
ZIP 27705

(919) 684-8111

KELLY B HAN M.D.

Student in an Organized Health Care Education/Training Program

2301 ERWIN RD
DURHAM, NC
ZIP 27705

(919) 684-8111

DUKE UNIVERSITY HOSPITAL

General Acute Care Hospital

2301 ERWIN RD
DURHAM, NC
ZIP 27705

(317) 502-6914

DR. EMMA CHRISTINE NEFF M.D.

Student in an Organized Health Care Education/Training Program

2301 ERWIN RD
DURHAM, NC
ZIP 27705

(919) 684-8111

DR. WASSIM SHATILA M.D.

Internal Medicine

2301 ERWIN RD
DURHAM, NC
ZIP 27705

(919) 699-4264

MR. CLIFTON EARL THOMPSON JR. PMHNP

Nurse Practitioner

(Psychiatric/Mental Health)

2301 ERWIN RD
DURHAM, NC
ZIP 27705

(919) 681-4402

MARGARET ANNE MURPHY ACNP

Nurse Practitioner

(Acute Care)

2301 ERWIN RD
DURHAM, NC
ZIP 27705

(919) 681-3241

DR. BRET STEVEN POWELL D.O., M.P.H.

Student in an Organized Health Care Education/Training Program

2301 ERWIN RD
DURHAM, NC
ZIP 27705

(919) 684-3491

DR. JOHN PATRICK YEATTS MD, MPH

Student in an Organized Health Care Education/Training Program

2301 ERWIN RD
DURHAM, NC
ZIP 27705

(919) 668-6577

VICTORIA MARIE PARENTE

Student in an Organized Health Care Education/Training Program

2301 ERWIN RD
DURHAM, NC
ZIP 27705

(919) 684-2356

BRICE NIELSEN LEFLER M.D.

Student in an Organized Health Care Education/Training Program

2301 ERWIN RD
DURHAM, NC
ZIP 27705

(919) 681-1464

JOHN DAVIES

Respiratory Therapist, Registered

2301 ERWIN RD
DURHAM, NC
ZIP 27705

(919) 681-4602

LYNDSEY NICOLE PRANGE CPNP

Nurse Practitioner

(Pediatrics)

2301 ERWIN RD
BOX 3936
DURHAM, NC
ZIP 27705

(919) 668-0477

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1790985810, enumerated as an "individual" on July 18, 2007.

The provider is located at 2301 ERWIN RD DURHAM, NC 27705 and the phone number is (919) 684-8964.

Internal Medicine with taxonomy code 207R00000X.

The provider might be accepting Accepts: Cigna Healthcare and Medica. Please consult your insurance carrier or call the provider to verify.

Rajnish Verma is affiliated with: DUKE UNIVERSITY HOSPITAL.