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ASHOK KUMAR PILLY M.D.
NPI 1801997523
Internal Medicine - Cardiovascular Disease in Edison, NJ

Active since September 26, 2006PECOS Enrolled
57.66/100
CMS Quality Rating
225 MAY ST, STE F, EDISON, NJ 08837(732) 738-8855 Get Directions Write a Review

NPPES record last updated: June 25, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Ashok Kumar Pilly M.d. NPPES

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

ASHOK KUMAR PILLY M.D. (NPI 1801997523) is an individual cardiovascular disease provider in Edison, New Jersey, licensed in New Jersey (25MA04302600) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS and maintains a secondary practice location in Vineland.

NPPES Registry Identity

NPI1801997523
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameASHOK KUMAR PILLYCredential: M.D.
Location Address225 MAY ST, STE FEdison, NJ 08837-3266
Mailing Address331 Newman Springs Rd, Bldg 2, Ste 220Red Bank, NJ 07701-5688
Phone(732) 738-8855
Sole ProprietorYes
Enumeration DateSeptember 26, 2006
Last NPPES UpdateJune 25, 2025
NPPES CertifiedJune 25, 2025
✔ NPI 1801997523 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License✔ Licensed in NJ · 25MA04302600
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
225 MAY ST, Edison, NJ 08837
Open in Google Maps ↗

Secondary Practice Location 1

Location 13662 S Delsea DrVineland, NJ 08360-7453 · Phone (856) 825-8100 · Fax (856) 825-8711

Other Identifiers 1

Medicaid0359602NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ashok Kumar Pilly M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Ashok Pilly reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Hackensack Meridian Health Medical Group - Primary Care PC
18 mi
Family Medicine
331 NEWMAN SPRINGS RD STE 220
Red Bank, NJ 07701
  • Reassigned Medicare billing, New Jersey enrollment
  • 689 clinicians in this Medicare group
NPI 1336203538 (732) 807-0800
The Radiology Group Of New Jersey, LLC
35 mi
Multi-Specialty
651 WILLOW GROVE ST
Hackettstown, NJ 07840
  • Reassigned Medicare billing, New Jersey enrollment
  • 429 clinicians in this Medicare group
NPI 1174010540 (908) 979-1621

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

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.
105 services55 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.
30 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.
19 services19 patients
Electrocardiogram (ecg) 2-day continuous with review and report by health care professional 93224
An Electrocardiogram (ECG) is a non-invasive test that records the electrical activity of your heart. In a 2-day continuous ECG, sensors attached to your chest monitor your heart's rhythm over 48 hours. A healthcare professional then reviews the data to identify any irregularities.
15 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08837 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
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$79.09 typical visit price
range $20.97 – $155.92
Typical copayment $19.77 (range $5.24 – $38.98)
Most-billed visit code 99213
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.

57.66/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality75.36
Promoting Interoperability0
Improvement Activities40

Reported Quality Measures

Coronary Artery Disease (CAD): Antiplatelet Therapy
Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease (CAD) seen within a 12 month period who were prescribed aspirin or clopidogrel
100%30 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%1,379 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%42 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
100%548 patients5/55-star benchmark: 99%
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…
100%486 patients5/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 452 patients
Patients tobacco: 100% · 452 patients
100%62 patients5/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
67%548 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
0%548 patients1/55-star benchmark: 59%
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 2

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$14.06 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$63.06 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.

DR. MALVIN S KELLER M.D.
Internal Medicine (Cardiovascular Disease)
225 MAY ST, SUITE F
EDISON, NJ 08837
Middlesex County (732) 738-8855
DR. LINDA MARIE NERI MD
Surgery
225 MAY ST, SUITE B
EDISON, NJ 08837
Middlesex County (732) 738-9292
MRS. BHAVANA REBBA M.D.
Internal Medicine
225 MAY ST, SUITE F
EDISON, NJ 08837
Middlesex County (732) 738-6232
MRS. VALSAMMA JOSEPH ANP-C
Nurse Practitioner (Adult Health)
225 MAY ST, SUITE F
EDISON, NJ 08837
Middlesex County (732) 738-8855
ANANGUR P SWAMINATHAN MD
Surgery
225 MAY ST, SUITE A
EDISON, NJ 08837
Middlesex County (732) 346-5400
MALGORZATA KUZA
Clinic/Center (Primary Care)
225 MAY ST, SUITE B
EDISON, NJ 08837
Middlesex County (732) 738-8837
DR. PETER CONRAD ROBLEJO M.D.
Psychiatry & Neurology (Neurology)
225 MAY ST
EDISON, NJ 08837
Middlesex County (723) 738-8830
DR. MARVIN A RUBINSTEIN M.D.
Internal Medicine (Cardiovascular Disease)
225 MAY ST, SUITE F
EDISON, NJ 08837
Middlesex County (732) 738-8855

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 Ashok Pilly's NPI number?

The NPI number for Ashok Pilly is 1801997523. It was assigned to this individual provider in the NPPES registry on September 26, 2006.

Where is Ashok Pilly located?

Ashok Pilly practices at 225 May St Ste F, Edison, NJ 08837. The listed phone number is (732) 738-8855.

What is Ashok Pilly's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Ashok Pilly enrolled in Medicare?

Yes. Ashok Pilly is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Ashok Pilly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ashok Pilly reassigns Medicare benefits to 2 organizations: Hackensack Meridian Health Medical Group - Primary Care PC (Red Bank, NJ) and The Radiology Group Of New Jersey, LLC (Hackettstown, NJ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ashok Pilly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ashok Pilly accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Ashok Pilly 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.

When was this NPI record last updated?

The NPPES record for Ashok Pilly was last updated on June 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.