PIYUSH BHATNAGAR M.D.
NPI 1811961907
Internal Medicine in Grand Rapids, MI
Active since February 15, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
1959 E PARIS AVE SE, GRAND RAPIDS, MI 49546(616) 808-2695(616) 808-2697 Get Directions Write a Review
About Piyush Bhatnagar M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PIYUSH BHATNAGAR M.D. (NPI 1811961907) is an individual internal medicine provider in Grand Rapids, Michigan, licensed in Michigan (4301072781) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Spectrum Health, and is a graduate of Other (1998).
NPPES Registry Identity
NPI1811961907
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NamePIYUSH BHATNAGARCredential: M.D.
Location Address1959 E PARIS AVE SEGrand Rapids, MI 49546-6272
Mailing Address1959 E Paris Ave SeGrand Rapids, MI 49546-6272 · (616) 808-2695 · Fax (616) 808-2697
Phone(616) 808-2695
Fax(616) 808-2697
Sole ProprietorNo
Medical School CMSOtherGraduated 1998
Enumeration DateFebruary 15, 2006
Last NPPES UpdateDecember 11, 2014
✔ NPI 1811961907 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 2
★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MI · 4301072781
Definition
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.
Also ListedHospitalistTaxonomy 208M00000X · License 4301072781 (MI)
1959 E PARIS AVE SE, Grand Rapids, MI 49546
Other Identifiers 1
Medicare UPINH55516
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, Priority Health.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
Piyush Bhatnagar 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 ID7618944067
PECOS Enrollment IDI20040914001245
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 12
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.
Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306
An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
279 services253 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
273 services107 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
199 services108 patients
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
86 services84 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
69 services54 patients
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.
52 services35 patients
Hospital Affiliations CMS Care Compare 4
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Spectrum Health
Acute Care Hospitals · Grand Rapids, MIOwnershipVoluntary non-profit - Private
CMS Certification Number230038
Location100 Michigan St NEGrand Rapids, MI 49503 · Kent County
Emergency services Birthing friendly
Mercy Health Saint Mary's
Acute Care Hospitals · Grand Rapids, MIOwnershipVoluntary non-profit - Church
CMS Certification Number230059
Location200 Jefferson Avenue SEGrand Rapids, MI 49503 · Kent County
Emergency services Birthing friendly
Holland Community Hospital
Acute Care Hospitals · Holland, MIOwnershipVoluntary non-profit - Private
CMS Certification Number230072
Location602 Michigan AveHolland, MI 49423 · Ottawa County
Emergency services Birthing friendly
Corewell Health Pennock Hospital
Critical Access Hospitals · Hastings, MIOwnershipVoluntary non-profit - Other
CMS Certification Number231339
Location1009 W Green StHastings, MI 49058 · Barry County
Emergency services Birthing friendly
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 49546 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
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.
100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment ModelQuality
87.54
Promoting Interoperability
100
Improvement Activities
40
Reported Quality Measures
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
55%136 patients3/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
56%103 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
51%335 patients3/55-star benchmark: 85%
Depression Utilization of the PHQ-9 Tool
The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit
Patients 4MonthsOfEnd: 3% · 33 patients
Patients 4MonthsOfStart: 3% · 34 patients
7%29 patients
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
14%51 patients1/55-star benchmark: 100%
Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
2%51 patients1/55-star benchmark: 98%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
84%51 patients4/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
97%1,044 patients4/55-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.
90%664 patients3/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
6%169 patients1/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
5%20 patients1/55-star benchmark: 88%
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.
99%188 patients4/55-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.
99%253 patients5/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
36%169 patients2/55-star benchmark: 90%
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…
28%551 patients2/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
50%458 patients3/55-star benchmark: 88%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
8%420 patients1/55-star benchmark: 96%
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% · 339 patients
Patients tobacco: 93% · 339 patients
17%29 patients1/55-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…
100%253 patients5/55-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…
30%253 patients2/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 4% · 169 patients
12%169 patients2/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
60%253 patients
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 10
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) A4314
DME-Orthotic Devices · category DF000N
2 suppliers11 claims11 services$24.25 avg. paid by Medicare
Collagen dressing, sterile, size 16 sq. in. or less, each A6021
DME-Medical/Surgical Supplies · category DA023N
3 suppliers12 claims288 services$19.62 avg. paid by Medicare
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing A6196
DME-Medical/Surgical Supplies · category DA023N
3 suppliers25 claims668 services$7.08 avg. paid by Medicare
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6212
DME-Medical/Surgical Supplies · category DA023N
3 suppliers23 claims276 services$9.37 avg. paid by Medicare
Commode chair, mobile or stationary, with detachable arms E0165
DME-Other DME · category DE000N
3 suppliers20 claims20 services$6.54 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress E0261
DME-Hospital Beds · category DB000N
2 suppliers17 claims17 services$38.38 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.
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 Piyush Bhatnagar's NPI number?
The NPI number for Piyush Bhatnagar is 1811961907. It was assigned to this individual provider in the NPPES registry on February 15, 2006.
Where is Piyush Bhatnagar located?
Piyush Bhatnagar practices at 1959 E Paris Ave SE, Grand Rapids, MI 49546. The listed phone number is (616) 808-2695.
What is Piyush Bhatnagar's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Piyush Bhatnagar enrolled in Medicare?
Yes. Piyush Bhatnagar 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 Piyush Bhatnagar accept?
Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and Priority Health list Piyush Bhatnagar 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 Piyush Bhatnagar affiliated with any hospitals?
According to CMS data, Piyush Bhatnagar is affiliated with Spectrum Health, Mercy Health Saint Mary's, Holland Community Hospital and Corewell Health Pennock Hospital.
When was this NPI record last updated?
The NPPES record for Piyush Bhatnagar was last updated on December 11, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Piyush Bhatnagar, M.D. · NPI 1811961907
Internal Medicine physician in Grand Rapids, Michigan. Individual provider, active in the CMS NPPES registry since February 15, 2006.
## Identity
- **NPI:** 1811961907 (Entity type: Individual)
- **Enumerated:** February 15, 2006
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** 4301072781 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 1959 E PARIS AVE SE, Grand Rapids, MI 49546-6272
- **Phone:** (616) 808-2695 · **Fax:** (616) 808-2697
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 1998
## Record status
- **NPPES last updated:** December 11, 2014
- **Other identifiers:** Medicare UPIN H55516
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Source: [NPI Profile](https://npiprofile.com/npi/1811961907) · Data from the CMS NPPES public registry.