MRIDULA RAI MD
NPI 1851619894
Internal Medicine - Cardiovascular Disease in Albuquerque, NM

Q: What is Mridula Rai's NPI number?

The NPI number for Mridula Rai is 1851619894. It was assigned to this individual provider in the NPPES registry on May 15, 2010.

Q: What is Mridula Rai's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Mridula Rai was last updated on March 19, 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.

Active since May 15, 2010PECOS EnrolledAccepts Medicare Assignment

97.58/100

CMS Quality Rating

502 ELM ST NE, ALBUQUERQUE, NM 87102(505) 841-1000 Get Directions Write a Review

NPPES record last updated: March 19, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Mridula Rai Md NPPES

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

MRIDULA RAI MD (NPI 1851619894) is an individual cardiovascular disease provider in Albuquerque, New Mexico, licensed in New Mexico (MD2016-0323) and active in the NPI registry since May 2010. She is enrolled in Medicare PECOS, is affiliated with Unm Hospital, and maintains a secondary practice location in Norwich.

NPPES Registry Identity

NPI1851619894

Entity TypeIndividualFemale

Primary Taxonomy207RC0000X

Provider Legal NameMRIDULA RAICredential: MD

Location Address502 ELM ST NEAlbuquerque, NM 87102

Mailing Address502 Elm St NeAlbuquerque, NM 87102-2512 · (505) 841-1000

Phone(505) 841-1000

Sole ProprietorNo

Medical School CMSOtherGraduated 2007

Enumeration DateMay 15, 2010

Last NPPES UpdateMarch 19, 2019

✔ NPI 1851619894 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

Licenses✔ Licensed in NM · MD2016-0323✔ Licensed in CT · 054061

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.

502 ELM ST NE, Albuquerque, NM 87102

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Secondary Practice Location 1

Location 1164 Otrobando AveNorwich, CT 06360-2116 · Phone (860) 886-0023 · Fax (860) 886-0024

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

Mridula Rai 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 ID1355652496

PECOS Enrollment IDI20160713002026

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

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

Lovelace Health System LLC

0.2 mi

Diagnostic Radiology

601 MARTIN LUTHER KING AVE NE
Albuquerque, NM 87102

Reassigned Medicare billing, New Mexico enrollment
59 clinicians in this Medicare group

NPI 1275711178 (505) 727-8000

Southwest Medical Associates, LLC

5.5 mi

General Practice

6701 JEFFERSON ST NE
Albuquerque, NM 87109

Reassigned Medicare billing, New Mexico enrollment
554 clinicians in this Medicare group

NPI 1164491072 (505) 727-6200

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 29

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.

757 services540 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

649 services633 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

499 services77 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

405 services392 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

186 services186 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

172 services61 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.

170 services170 patients

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.

162 services109 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

139 services139 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

126 services125 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

120 services120 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.

113 services86 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

54 services47 patients

Ct scan of blood vessels and grafts of heart with contrast 75574

A CT scan of the heart's blood vessels and grafts with contrast is a diagnostic test. A special dye (contrast) is injected into your veins, which helps create clear images of your heart's vessels and grafts. This helps doctors detect blockages or other abnormalities.

37 services37 patients

Ultrasound of heart during rest, exercise and/or drug-induced stress with report 93350

This procedure involves using ultrasound imaging to view your heart at rest, during exercise, and/or under drug-induced stress. It helps assess how well your heart responds to exertion. A report of the findings is provided after the test.

37 services37 patients

Ultrasound of heart with probe in esophagus, with report 93312

This procedure, called a transesophageal echocardiogram, uses a small probe passed into your esophagus to capture detailed images of your heart. The report provides information about your heart's structure and function.

36 services31 patients

Smoking and tobacco use intensive counseling, 4-10 minutes 99406

This service provides brief, intensive counseling (4-10 minutes) to support you in quitting smoking or tobacco use. It involves discussing the risks of tobacco use, benefits of quitting, and strategies to help you stop. It's a critical step towards a healthier lifestyle.

36 services26 patients

Ultrasound of heart with color-depicted blood flow, rate and valve function 93325

An ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.

29 services28 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

27 services27 patients

Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan 78431

This is a diagnostic test where a tiny amount of radioactive material is used to examine your heart's blood flow at rest & during stress, alongside a CT scan for detailed images. It helps identify any heart-related issues like blockages or damage.

25 services25 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.

25 services25 patients

Ultrasound of heart blood flow, valves and chambers, follow-up 93321

This procedure, an echocardiogram, uses sound waves to create images of your heart. It aids in assessing your heart's blood flow, chambers, and valves. It's a follow-up procedure, ensuring that your heart is functioning properly post-treatment.

23 services23 patients

Ultrasound of heart with continuous electrocardiogram (ecg) during rest, exercise and/or drug induced stress with review and report 93351

This procedure involves using ultrasound technology to create images of your heart while you rest, exercise, or undergo drug-induced stress. An ECG continuously monitors your heart's electrical activity. It helps doctors assess heart health and function.

20 services20 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

17 services12 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.

15 services14 patients

Ct scan of heart structure with contrast 75572

A CT scan of the heart with contrast is a non-invasive test. A dye is injected into your veins, which helps to highlight heart structures in the images. The CT scanner uses X-rays to create detailed pictures of your heart, aiding in diagnosis.

12 services12 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

12 services11 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

12 services12 patients

Ct scan of heart with evaluation of blood vessel calcium 75571

A CT scan of the heart with evaluation of blood vessel calcium is a non-invasive test that uses X-rays to create detailed images of your heart. It helps in detecting and measuring calcium-containing plaque in the arteries, which can indicate heart disease.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Unm Hospital

Acute Care Hospitals · Albuquerque, NM

2/5 CMS rating

OwnershipGovernment - State

CMS Certification Number320001

Location2211 Lomas Boulevard NEAlbuquerque, NM 87106 · Bernalillo County

Emergency services Birthing friendly

Lovelace Medical Center

Acute Care Hospitals · Albuquerque, NM

3/5 CMS rating

OwnershipProprietary

CMS Certification Number320009

Location601 Dr Martin Luther King Jr Ave NEAlbuquerque, NM 87102 · Bernalillo County

Emergency services

Lovelace Women's Hospital

Acute Care Hospitals · Albuquerque, NM

1/5 CMS rating

OwnershipProprietary

CMS Certification Number320017

Location4701 Montgomery Boulevard NEAlbuquerque, NM 87109 · Bernalillo County

Emergency services Birthing friendly

Presbyterian Hospital

Acute Care Hospitals · Albuquerque, NM

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number320021

Location1100 Central Avenue SEAlbuquerque, NM 87106 · Bernalillo County

Emergency services Birthing friendly

Lovelace Westside Hospital

Acute Care Hospitals · Albuquerque, NM

2/5 CMS rating

OwnershipProprietary

CMS Certification Number320074

Location10501 Golf Course Road NWAlbuquerque, NM 87114 · Bernalillo County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87102 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

$126.21 typical visit price

range $54.26 – $166.80

Typical copayment $31.55 (range $13.56 – $41.70)

Most-billed visit code 99204

Established Patient

$68.00 typical visit price

range $17.00 – $135.35

Typical copayment $17.00 (range $4.25 – $33.83)

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.

97.58/100

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

Scored through an Alternative Payment Model

Quality

86.53

Promoting Interoperability

100

Improvement Activities

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.

100%2,455 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.

94%2,892 patients4/55-star benchmark: 99%

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.

94%516 patients3/55-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.

60%3,606 patients3/55-star benchmark: 97%

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…

42%1,745 patients2/55-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: 99% · 549 patients

Patients tobacco: 61% · 28 patients

97%549 patients4/55-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…

81%3,606 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 CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

37%3,606 patients2/55-star benchmark: 89%

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.

48%3,606 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.

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. BRENDAN J CAVANAUGH MD

Internal Medicine (Cardiovascular Disease)