POORNIMA RAO MD
NPI 1831395359
Internal Medicine - Endocrinology, Diabetes & Metabolism in Wexford, PA

Q: What is Poornima Rao's NPI number?

The NPI number for Poornima Rao is 1831395359. It was assigned to this individual provider in the NPPES registry on June 22, 2007.

Q: What is Poornima Rao's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Poornima Rao was last updated on October 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since June 22, 2007PECOS EnrolledAccepts Medicare Assignment

93.78/100

CMS Quality Rating

12311 PERRY HWY, WEXFORD, PA 15090(724) 941-7490(724) 941-5231 Get Directions Write a Review

NPPES record last updated: October 9, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 9, 2020, Sep 18, 2018, Apr 26, 2017 (3 updates tracked since 2017).

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About Poornima Rao Md NPPES

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

POORNIMA RAO MD (NPI 1831395359) is an individual endocrinology, diabetes & metabolism provider in Wexford, Pennsylvania, licensed in Pennsylvania (MD419873) and active in the NPI registry since June 2007. She is enrolled in Medicare PECOS, is affiliated with Allegheny General Hospital, and is a graduate of Other (1995).

NPPES Registry Identity

NPI1831395359

Entity TypeIndividualFemale

Primary Taxonomy207RE0101X

Provider Legal NamePOORNIMA RAOCredential: MD

Location Address12311 PERRY HWYWexford, PA 15090-8344

Mailing Address12311 Perry HwyWexford, PA 15090-8344 · (724) 941-7490 · Fax (724) 941-5231

Phone(724) 941-7490

Fax(724) 941-5231

Sole ProprietorNo

Medical School CMSOtherGraduated 1995

Enumeration DateJune 22, 2007

Last NPPES UpdateOctober 9, 20203 updates tracked since enumeration

NPPES CertifiedOctober 9, 2020

✔ NPI 1831395359 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 PA · MD419873

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.

12311 PERRY HWY, Wexford, PA 15090

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Poornima Rao Md 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 ID4082680970

PECOS Enrollment IDI20040902000315

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 Reassignment

Medicare enrollment records show Poornima Rao reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Allegheny Clinic

Same address

Family Medicine

12311 PERRY HWY
Wexford, PA 15090

Reassigned Medicare billing, Pennsylvania enrollment
2,881 clinicians in this Medicare group

NPI 1245639749 (878) 332-4159

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 7

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.

342 services233 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.

54 services40 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

54 services26 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.

21 services21 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.

15 services14 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

12 services12 patients

Hospital Affiliations CMS Care Compare 5

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

Allegheny General Hospital

Acute Care Hospitals · Pittsburgh, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390050

Location320 East North AvenuePittsburgh, PA 15212 · Allegheny County

Emergency services

West Penn Hospital

Acute Care Hospitals · Pittsburgh, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390090

Location4800 Friendship AvenuePittsburgh, PA 15224 · Allegheny County

Emergency services Birthing friendly

Canonsburg General Hospital

Acute Care Hospitals · Canonsburg, PA

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number390160

Location100 Medical BoulevardCanonsburg, PA 15317 · Washington County

Emergency services

Grove City Medical Center

Acute Care Hospitals · Grove City, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390266

Location631 North Broad Street Ext.Grove City, PA 16127 · Mercer County

Emergency services

Ahn Wexford Hospital

Acute Care Hospitals · Wexford, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390334

Location12351 Perry HighwayWexford, PA 15090 · Allegheny County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15090 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

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

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.

93.78/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

85.07

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 9

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

Supplies for maintenance of insulin infusion catheter, per week A4224

DME-Other DME · category DE017N

6 suppliers28 claims374 services$18.49 avg. paid by Medicare

Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225

DME-Other DME · category DE017N

6 suppliers28 claims1,010 services$2.37 avg. paid by Medicare

Supply allowance for adjunctive continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service A4238

DME-Medical/Surgical Supplies · category DA000N

1 supplier14 claims14 services$173.28 avg. paid by Medicare

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

26 suppliers112 claims423 services$6.13 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

12 suppliers19 claims37 services$1.06 avg. paid by Medicare

External ambulatory infusion pump, insulin E0784

DME-Other DME · category DE017N

2 suppliers11 claims11 services$345.48 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.

BRODY WOOD PT, DPT

Physical Therapist