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DR. PAYAM POOYAN M.D.
NPI 1841254265
Internal Medicine - Pulmonary Disease in Leesburg, VA

Active since April 13, 2006PECOS EnrolledAccepts Medicare Assignment
77.78/100
CMS Quality Rating
19455 DEERFIELD AVE STE 206, LEESBURG, VA 20176(703) 858-9608(703) 858-9618 Get Directions Write a Review

NPPES record last updated: July 10, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 10, 2023, Jun 11, 2019, Jun 16, 2018 and 2 more (5 updates tracked since 2017).

About Dr. Payam Pooyan M.d. NPPES

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

DR. PAYAM POOYAN M.D. (NPI 1841254265) is an individual pulmonary disease provider in Leesburg, Virginia, licensed in Virginia (0101257751) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Johnson City, and is a graduate of Other (1994).

NPPES Registry Identity

NPI1841254265
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameDR. PAYAM POOYANCredential: M.D.
Location Address19455 DEERFIELD AVE STE 206Leesburg, VA 20176-8102
Mailing Address19455 Deerfield Ave Ste 206Leesburg, VA 20176-8102 · (703) 858-9608 · Fax (703) 858-9618
Phone(703) 858-9608
Fax(703) 858-9618
Sole ProprietorNo
Medical School CMSOtherGraduated 1994
Enumeration DateApril 13, 2006
Last NPPES UpdateJuly 10, 20235 updates tracked since enumeration
NPPES CertifiedJuly 10, 2023
✔ NPI 1841254265 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in VA · 0101257751
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal Medicine · Sleep MedicineTaxonomy 207RS0012X · License 0101257751 (VA)
Also ListedHospitalistTaxonomy 208M00000X · License 37872 (TN)
19455 DEERFIELD AVE STE 206, Leesburg, VA 20176
Open in Google Maps ↗

Secondary Practice Location 1

Location 1119 Boone Ridge Dr, Suite 201Johnson City, TN 37615-4998 · Phone (423) 282-1480 · Fax (423) 928-1353

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, CareSource, Molina Healthcare.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. Payam Pooyan 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 ID4981674983
PECOS Enrollment IDI20150625002437
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 3

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
187 services165 patients
Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth G0509
A telehealth consultation for critical care is a virtual meeting with a doctor for ongoing critical health issues. It involves a 50-minute session where the physician connects with the patient and other healthcare providers to discuss and manage the patient's condition. This method ensures safe, convenient care.
105 services83 patients
Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth G0508
A telehealth consultation for critical care is a virtual meeting with a physician, typically lasting 60 minutes. Here, the doctor assesses your health condition, provides guidance, and communicates with other care providers, all through digital platforms. It's a safe, convenient way to receive critical care.
80 services80 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20176 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
$129.04 typical visit price
range $56.19 – $170.30
Typical copayment $32.26 (range $14.04 – $42.57)
Most-billed visit code 99204
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
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.

77.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality73.47
Promoting Interoperability84
Improvement Activities40
Cost65.8

Reported Quality Measures

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%1,379 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.
88%1,018 patients4/55-star benchmark: 100%
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
71%339 patients3/55-star benchmark: 99%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…
24%836 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
23%339 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…
29%696 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
43%373 patients2/55-star benchmark: 88%
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% · 388 patients
Patients tobacco: 93% · 388 patients
15%33 patients1/55-star benchmark: 98%
Provide Patient Access
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…
87%836 patients4/55-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 certified EHR technology to the patient (or the patient-authorized representative), or in…
16%836 patients1/55-star benchmark: 75%
View, Download and Transmit (VDT)
During the performance period, at least one unique patient (or patient-authorized representatives) seen by the MIPS eligible clinician actively engages with the EHR made accessible by the MIPS eligible clinician.
0%936 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 26

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
15 suppliers99 claims99 services$30.21 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
3 suppliers17 claims34 services$1.02 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
7 suppliers47 claims47 services$73.46 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
8 suppliers52 claims135 services$29.07 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
9 suppliers51 claims301 services$14.17 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
3 suppliers19 claims111 services$12.23 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

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

PULMONARY AND CRITICAL CARE ASSOCIATES, P.C.
Internal Medicine (Pulmonary Disease)
19455 DEERFIELD AVE STE 206
LEESBURG, VA 20176
Loudoun County (703) 858-9608

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 Payam Pooyan's NPI number?

The NPI number for Payam Pooyan is 1841254265. It was assigned to this individual provider in the NPPES registry on April 13, 2006.

Where is Payam Pooyan located?

Payam Pooyan practices at 19455 Deerfield Ave Ste 206, Leesburg, VA 20176. The listed phone number is (703) 858-9608.

What is Payam Pooyan's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Payam Pooyan enrolled in Medicare?

Yes. Payam Pooyan 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 Payam Pooyan accept?

Health plans from Blue Cross and Blue Shield of Texas, CareSource and Molina Healthcare list Payam Pooyan 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 Payam Pooyan was last updated on July 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.