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DR. POOJA RAGHAVAN M.D.
NPI 1801026810
Internal Medicine - Endocrinology, Diabetes & Metabolism in Winston Salem, NC

Active since July 24, 2009PECOS EnrolledAccepts Medicare Assignment
755 HIGHLAND OAKS DR, STE 201, WINSTON SALEM, NC 27103(336) 765-0020(336) 765-0581 Get Directions Write a Review

NPPES record last updated: October 25, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 25, 2020, Oct 17, 2016 (2 updates tracked since 2016).

About Dr. Pooja Raghavan M.d. NPPES

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

DR. POOJA RAGHAVAN M.D. (NPI 1801026810) is an individual endocrinology, diabetes & metabolism provider in Winston Salem, North Carolina, licensed in North Carolina (2016-01930) and active in the NPI registry since July 2009. She is enrolled in Medicare PECOS, is affiliated with Novant Health Forsyth Medical Center, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1801026810
Entity TypeIndividualFemale
Primary Taxonomy207RE0101X
Provider Legal NameDR. POOJA RAGHAVANCredential: M.D.
Location Address755 HIGHLAND OAKS DR, STE 201Winston Salem, NC 27103-7106
Mailing AddressPo Box 751803Charlotte, NC 28275-1803 · (336) 765-0020 · Fax (336) 765-0581
Phone(336) 765-0020
Fax(336) 765-0581
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateJuly 24, 2009
Last NPPES UpdateOctober 25, 20202 updates tracked since enumeration
NPPES CertifiedSeptember 6, 2020
✔ NPI 1801026810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in NC · 2016-01930
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.

755 HIGHLAND OAKS DR, Winston Salem, NC 27103
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.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. Pooja Raghavan M.d. 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 ID6103008115
PECOS Enrollment IDI20161128001561
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.

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.
299 services184 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.
95 services44 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.
70 services63 patients
Ultrasound scan of head and neck soft tissue 76536
An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.
58 services57 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
30 services25 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.
28 services28 patients

Hospital Affiliations CMS Care Compare

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

Novant Health Forsyth Medical Center

Acute Care Hospitals · Winston-Salem, NC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340014
Location3333 Silas Creek ParkwayWinston-Salem, NC 27103 · Forsyth County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27103 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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
91%167 patients4/55-star benchmark: 100%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
90%87 patients4/55-star benchmark: 100%
Elder Maltreatment Screen and Follow-Up Plan
Percentage of patients aged 65 years and older with a documented elder maltreatment screen using an Elder Maltreatment Screening Tool on the date of encounter AND a documented follow-up plan on the date of the positive screen
14%201 patients1/55-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
73%201 patients3/55-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…
41%239 patients2/55-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
68%114 patients3/55-star benchmark: 98%
Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older
Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months
3%150 patients1/55-star benchmark: 100%
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.

Referred Medical Equipment & Supplies CMS DME claims 4

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
24 suppliers83 claims274 services$6.51 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
9 suppliers14 claims34 services$1.18 avg. paid by Medicare
Insulin for administration through dme (i.e., insulin pump) per 50 units J1817
Treatment-Injections and Infusions (nononcologic) · category RI000N
3 suppliers11 claims1,180 services$6.86 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
16 suppliers137 claims138 services$191.12 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 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DIANA E LIZARDO-MORALES MD
Family Medicine
755 HIGHLAND OAKS DR, STE 202
WINSTON-SALEM, NC 27103
Forsyth County (336) 760-0070
MR. ANTHONY TONOS MD
Internal Medicine
755 HIGHLAND OAKS DR, SUITE 202
WINSTON SALEM, NC 27103
Forsyth County (336) 760-0070
ICLINIC, PA
Internal Medicine
755 HIGHLAND OAKS DR, SUITE 202
WINSTON-SALEM, NC 27103
Forsyth County (336) 760-0070
ANNE CATH MD PLLC
Internal Medicine
755 HIGHLAND OAKS DR, SUITE 102
WINSTON SALEM, NC 27103
Forsyth County (336) 768-4460
LLOYD J STORY MD, PA
Internal Medicine
755 HIGHLAND OAKS DR, SUITE 102
WINSTON SALEM, NC 27103
Forsyth County (336) 768-4460
NEAL HAMILTON GUFFEY, JR. MD PLLC
Family Medicine
755 HIGHLAND OAKS DR, SUITE 102
WINSTON SALEM, NC 27103
Forsyth County (336) 768-4460
FIFTH RIVER MENTAL HEALTH
Psychiatry & Neurology (Psychiatry)
755 HIGHLAND OAKS DR, SUITE 202
WINSTON SALEM, NC 27103
Forsyth County (336) 608-4060
LARRY KEITH CANTLEY MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
755 HIGHLAND OAKS DR, SUITE 201
WINSTON SALEM, NC 27103
Forsyth County (336) 765-0020

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 Pooja Raghavan's NPI number?

The NPI number for Pooja Raghavan is 1801026810. It was assigned to this individual provider in the NPPES registry on July 24, 2009.

Where is Pooja Raghavan located?

Pooja Raghavan practices at 755 Highland Oaks Dr Ste 201, Winston Salem, NC 27103. The listed phone number is (336) 765-0020.

What is Pooja Raghavan's specialty?

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

Is Pooja Raghavan enrolled in Medicare?

Yes. Pooja Raghavan 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 Pooja Raghavan accept?

Health plans from Blue Cross and Blue Shield of NC list Pooja Raghavan 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 Pooja Raghavan affiliated with any hospitals?

According to CMS data, Pooja Raghavan is affiliated with Novant Health Forsyth Medical Center.

When was this NPI record last updated?

The NPPES record for Pooja Raghavan was last updated on October 25, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.