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DR. RAGHAVENDRA V GHUGE MD
NPI 1891768461
Internal Medicine - Sleep Medicine in Tyler, TX

Active since February 13, 2006PECOS EnrolledAccepts Medicare Assignment
82.74/100
CMS Quality Rating
3187 PALUXY DR, TYLER, TX 75701(903) 787-7533(903) 787-8825 Get Directions Write a Review

NPPES record last updated: February 8, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 8, 2021, Mar 23, 2017 (2 updates tracked since 2017).

About Dr. Raghavendra V Ghuge Md NPPES

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

DR. RAGHAVENDRA V GHUGE MD (NPI 1891768461) is an individual sleep medicine provider in Tyler, Texas, licensed in Texas (K0769) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1988).

NPPES Registry Identity

NPI1891768461
Entity TypeIndividualMale
Primary Taxonomy207RS0012X
Provider Legal NameDR. RAGHAVENDRA V GHUGECredential: MD
Location Address3187 PALUXY DRTyler, TX 75701-8303
Mailing AddressPo Box 8270Tyler, TX 75711-8270 · (903) 787-7533 · Fax (903) 787-8825
Phone(903) 787-7533
Fax(903) 787-8825
Sole ProprietorNo
Medical School CMSOtherGraduated 1988
Enumeration DateFebruary 13, 2006
Last NPPES UpdateFebruary 8, 20212 updates tracked since enumeration
NPPES CertifiedFebruary 8, 2021
✔ NPI 1891768461 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Sleep MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RS0012X
License✔ Licensed in TX · K0769
Definition
An Internist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders.
3187 PALUXY DR, Tyler, TX 75701
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Other Identifiers 1

Medicaid031565702TX

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. Raghavendra V Ghuge 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 ID5597737098
PECOS Enrollment IDI20040806000120
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 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.
714 services393 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.
258 services191 patients
Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811
A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.
141 services141 patients
Sleep study including heart rate, breathing, and sleep time 95800
A sleep study monitors your sleep patterns to evaluate your sleep quality. It records your heart rate, breathing, and actual sleep time. This information helps identify any sleep disorders, ensuring you get the rest you need for optimal health.
67 services60 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
43 services43 patients
Sleep study in sleep lab (6 years or older) 95810
A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.
20 services20 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75701 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

82.74/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality65.48
Improvement Activities40

Reported Quality Measures

Cervical Cancer Screening
19%233 patients1/55-star benchmark: 98%
Documentation of Current Medications in the Medical Record
98%2,413 patients4/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
74%376 patients3/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 2% · 789 patients
Patients totalRate: 3% · 789 patients
1%789 patients4/55-star benchmark: 100%
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 17

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
11 suppliers50 claims50 services$39.89 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
14 suppliers176 claims176 services$95.94 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
14 suppliers192 claims461 services$37.24 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
14 suppliers186 claims953 services$22.06 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
17 suppliers400 claims1,989 services$16.12 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
22 suppliers524 claims524 services$61.81 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.

MRS. SHARON MALAURA MCELROY NP-C
Nurse Practitioner
3187 PALUXY DR
TYLER, TX 75701
Smith County (903) 787-7533

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 Raghavendra Ghuge's NPI number?

The NPI number for Raghavendra Ghuge is 1891768461. It was assigned to this individual provider in the NPPES registry on February 13, 2006.

Where is Raghavendra Ghuge located?

Raghavendra Ghuge practices at 3187 Paluxy Dr, Tyler, TX 75701. The listed phone number is (903) 787-7533.

What is Raghavendra Ghuge's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Sleep Medicine, with taxonomy code 207RS0012X.

Is Raghavendra Ghuge enrolled in Medicare?

Yes. Raghavendra Ghuge 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.

When was this NPI record last updated?

The NPPES record for Raghavendra Ghuge was last updated on February 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.