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POOJA PAUNIKAR
NPI 1801150297
Family Medicine in Riverhead, NY

Active since June 29, 2012PECOS EnrolledAccepts Medicare Assignment
35.31/100
CMS Quality Rating
34 COMMERCE AVE STE 1, RIVERHEAD, NY 11901(631) 727-1600 Get Directions Write a Review

NPPES record last updated: June 17, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 17, 2019, Sep 5, 2018, Dec 12, 2016 and 1 more (4 updates tracked since 2016).

About Pooja Paunikar NPPES

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

POOJA PAUNIKAR (NPI 1801150297) is an individual family medicine provider in Riverhead, New York, licensed in New York (280203) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS, is affiliated with Musc Medical Center, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1801150297
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NamePOOJA PAUNIKAR
Location Address34 COMMERCE AVE STE 1Riverhead, NY 11901-3118
Mailing Address185 Old Country Rd Ste 2Riverhead, NY 11901-2121 · (631) 298-4479 · Fax (631) 591-3047
Phone(631) 727-1600
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateJune 29, 2012
Last NPPES UpdateJune 17, 20194 updates tracked since enumeration
✔ NPI 1801150297 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NY · 280203
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.
34 COMMERCE AVE STE 1, Riverhead, NY 11901
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina 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

Pooja Paunikar 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 ID5890003594
PECOS Enrollment IDI20150930000016, I20230724004083
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.

Hospital Affiliations CMS Care Compare 2

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

Musc Medical Center

Acute Care Hospitals · Charleston, SC
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number420004
Location169 Ashley AveCharleston, SC 29425 · Charleston County
Emergency services Birthing friendly

Trident Medical Center

Acute Care Hospitals · Charleston, SC
3/5 CMS rating
OwnershipProprietary
CMS Certification Number420079
Location9330 Medical Plaza DrCharleston, SC 29406 · Charleston County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11901 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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.

35.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality23.97
Promoting Interoperability0
Improvement Activities20
Cost68.73

Other Providers at the Same Location NPPES

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

DENNIS TAMBE BESONG M.D.
Family Medicine
34 COMMERCE AVE STE 1
RIVERHEAD, NY 11901
Suffolk County (631) 727-1600

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 Paunikar's NPI number?

The NPI number for Pooja Paunikar is 1801150297. It was assigned to this individual provider in the NPPES registry on June 29, 2012.

Where is Pooja Paunikar located?

Pooja Paunikar practices at 34 Commerce Ave Ste 1, Riverhead, NY 11901. The listed phone number is (631) 727-1600.

What is Pooja Paunikar's specialty?

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

Is Pooja Paunikar enrolled in Medicare?

Yes. Pooja Paunikar 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 Paunikar accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina, First Choice Next and UnitedHealthcare list Pooja Paunikar 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 Paunikar affiliated with any hospitals?

According to CMS data, Pooja Paunikar is affiliated with Musc Medical Center and Trident Medical Center.

When was this NPI record last updated?

The NPPES record for Pooja Paunikar was last updated on June 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.