SANJAY GARG M.D.
NPI 1891997458
Internal Medicine - Rheumatology in Fayetteville, NC

Q: What is Sanjay Garg's NPI number?

The NPI number for Sanjay Garg is 1891997458. It was assigned to this individual provider in the NPPES registry on June 4, 2007.

Q: What is Sanjay Garg's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Q: When was this NPI record last updated?

The NPPES record for Sanjay Garg was last updated on February 7, 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.

Active since June 04, 2007PECOS EnrolledAccepts Medicare Assignment

97.58/100

CMS Quality Rating

2125 VALLEYGATE DR STE 201, FAYETTEVILLE, NC 28304(910) 920-1450(910) 920-1864 Get Directions Write a Review

NPPES record last updated: February 7, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 7, 2023, Jun 10, 2022 (2 updates tracked since 2022).

On this page

About Sanjay Garg M.d. NPPES

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

SANJAY GARG M.D. (NPI 1891997458) is an individual rheumatology provider in Fayetteville, North Carolina, licensed in North Carolina (2007-01588) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS, is affiliated with Cape Fear Valley Medical Center, and is a graduate of Other (1986).

NPPES Registry Identity

NPI1891997458

Entity TypeIndividualMale

Primary Taxonomy207RR0500X

Provider Legal NameSANJAY GARGCredential: M.D.

Location Address2125 VALLEYGATE DR STE 201Fayetteville, NC 28304-3754

Mailing Address2125 Valleygate Dr Ste 201Fayetteville, NC 28304-3754 · (910) 920-1450 · Fax (910) 920-1864

Phone(910) 920-1450

Fax(910) 920-1864

Sole ProprietorYes

Medical School CMSOtherGraduated 1986

Enumeration DateJune 4, 2007

Last NPPES UpdateFebruary 7, 20232 updates tracked since enumeration

NPPES CertifiedFebruary 7, 2023

✔ NPI 1891997458 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians

Taxonomy Code207RR0500X

License✔ Licensed in NC · 2007-01588

Definition

An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.

2125 VALLEYGATE DR STE 201, Fayetteville, NC 28304

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Blue Cross and Blue Shield of NC, UnitedHealthcare.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

Sanjay Garg 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 ID8022189109

PECOS Enrollment IDI20080617000547

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 25

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.

Injection, tocilizumab, 1 mg J3262

Tocilizumab is a medication administered via injection. It's used to treat certain conditions like rheumatoid arthritis by reducing inflammation in the body. It works by blocking a substance in the body that leads to inflammation.

60,280 services13 patients

Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) J0717

Certolizumab pegol is a medication injected under a doctor's supervision. It's used to treat certain inflammatory conditions like rheumatoid arthritis. The injection helps reduce symptoms like pain and swelling. Note that this drug isn't for self-administration.

38,800 services12 patients

Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) J0129

Abatacept is a medication administered via injection under a doctor's supervision. It's used to treat conditions like rheumatoid arthritis by moderating the immune system. This code applies when the doctor administers the drug, not for self-administration.

12,775 services22 patients

Injection, golimumab, 1 mg, for intravenous use J1602

Golimumab is a medication given through an IV (a small tube in your vein). It helps to reduce inflammation and pain by blocking a protein in your body that causes inflammation. It's often used to treat conditions like rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.

12,300 services14 patients

Injection, infliximab, excludes biosimilar, 10 mg J1745

Infliximab is a medication given via injection to treat certain autoimmune conditions. It works by blocking the action of a substance in your body that causes inflammation. Each dose is based on your medical condition and response to treatment.

7,070 services26 patients

Injection, rituximab, 10 mg J9312

Rituximab is a medication given via injection. It's used to treat certain types of cancer and autoimmune diseases. The 10 mg dosage refers to the amount of the drug in the injection. It works by targeting and destroying specific cells, helping your body's immune system.

4,200 services15 patients

Injection, denosumab, 1 mg J0897

Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.

4,080 services41 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.

955 services495 patients

Administration of chemotherapy into vein, 1 hour or less 96413

Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.

646 services102 patients

Administration of chemotherapy into vein, each additional hour 96415

Chemotherapy is a treatment method that uses drugs to destroy cancer cells. The drugs are administered into a vein, usually in the arm. Each additional hour of chemotherapy allows for more of the medication to enter your bloodstream to fight against the cancer cells.

338 services58 patients

Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle 96401

This procedure involves giving anti-cancer drugs, which don't contain hormones, into the muscle or under the skin. These drugs help to stop the growth of cancer cells. The process is usually quick and done by a healthcare professional.

328 services57 patients

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

267 services54 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.

191 services158 patients

Injection, zoledronic acid, 1 mg J3489

Zoledronic acid is a medication given via injection to strengthen bones. It's often used in patients with osteoporosis or certain types of cancer. The injection helps reduce the risk of fractures and other bone complications.

125 services25 patients

Injection of additional new drug or substance into vein 96375

This procedure involves introducing a new medication or substance into your bloodstream via a vein. It's typically done using a small needle. The substance can help treat various conditions or assist in diagnostic procedures. It's generally safe and monitored by professionals.

88 services24 patients

Injection, diphenhydramine hcl, up to 50 mg J1200

Diphenhydramine HCL injection is a medicine given to alleviate symptoms of allergies, colds, or hay fever. It can also help with motion sickness and certain symptoms of Parkinson's disease. Up to 50 mg may be administered depending on your condition.

75 services22 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.

60 services60 patients

X-ray of hand, minimum of 3 views 73130

An X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.

55 services52 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

53 services36 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

31 services19 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less 96365

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

25 services25 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 services13 patients

X-ray of joint between lower spine and hip bone, 3 or more views 72202

This procedure involves taking X-ray images of the joint connecting your lower spine and hip bone from three or more angles. It helps in diagnosing conditions like arthritis or fractures. You'll be positioned carefully, and the X-ray machine will capture the images.

12 services12 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

11 services11 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Cape Fear Valley Medical Center

Acute Care Hospitals · Fayetteville, NC

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number340028

Location1638 Owen Drive P O Box 2000Fayetteville, NC 28302 · Cumberland County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28304 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

$125.01 typical visit price

range $54.12 – $165.09

Typical copayment $31.25 (range $13.53 – $41.27)

Most-billed visit code 99204

Established Patient

$95.94 typical visit price

range $17.21 – $134.61

Typical copayment $23.98 (range $4.30 – $33.65)

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.

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%3,851 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.

84%1,801 patients4/55-star benchmark: 100%

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…

51%124 patients3/55-star benchmark: 98%

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.

93%890 patients4/55-star benchmark: 100%

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…

86%1,398 patients4/55-star benchmark: 100%

Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user

100%1,076 patients5/55-star benchmark: 100%

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…

85%890 patients4/55-star benchmark: 100%

Psoriasis: Tuberculosis (TB) Prevention for Patients with Psoriasis, Psoriatic Arthritis and Rheumatoid Arthritis Patients on a Biological Immune Response Modifier

Percentage of patients whose providers are ensuring active tuberculosis prevention either through yearly negative standard tuberculosis screening tests or are reviewing the patient's history to determine if they have had appropriate management for a recent or…

98%288 patients

Rheumatoid Arthritis (RA): Assessment and Classification of Disease Prognosis

Percentage of patients aged 18 years and older with a diagnosis of rheumatoid arthritis (RA) who have an assessment and classification of disease prognosis at least once within 12 months

100%518 patients5/55-star benchmark: 100%

Rheumatoid Arthritis (RA): Functional Status Assessment

Percentage of patients aged 18 years and older with a diagnosis of rheumatoid arthritis (RA) for whom a functional status assessment was performed at least once within 12 months

100%518 patients5/55-star benchmark: 100%

Rheumatoid Arthritis (RA): Glucocorticoid Management

Percentage of patients aged 18 years and older with a diagnosis of rheumatoid arthritis (RA) who have been assessed for glucocorticoid use and, for those on prolonged doses of prednisone >= 10 mg daily (or equivalent) with improvement or no change in disease…

100%518 patients5/55-star benchmark: 100%

Rheumatoid Arthritis (RA): Periodic Assessment of Disease Activity

Percentage of patients aged 18 years and older with a diagnosis of rheumatoid arthritis (RA) who have an assessment and classification of disease activity within 12 months

100%518 patients5/55-star benchmark: 100%

Rheumatoid Arthritis (RA): Tuberculosis Screening

Percentage of patients aged 18 years and older with a diagnosis of rheumatoid arthritis (RA) who have documentation of a tuberculosis (TB) screening performed and results interpreted within 6 months prior to receiving a first course of therapy using a…

85%316 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…

48%890 patients3/55-star benchmark: 79%

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 3

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

MICHELE T PROVOST PA

Physician Assistant

2125 VALLEYGATE DR STE 201
FAYETTEVILLE, NC 28304

Cumberland County (910) 920-1450

AMERICAN ARTHRITIS & RHEUMATOLOGY ASSOCIATES-NC PLLC

Internal Medicine (Rheumatology)

2125 VALLEYGATE DR STE 201
FAYETTEVILLE, NC 28304

Cumberland County (910) 323-1322

CAROLINA RHEUMATOLOGY & INTERNAL MEDICINE, PA

Internal Medicine (Rheumatology)

2125 VALLEYGATE DR STE 201
FAYETTEVILLE, NC 28304

Cumberland County (910) 920-1450

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 Sanjay Garg's NPI number?

The NPI number for Sanjay Garg is 1891997458. It was assigned to this individual provider in the NPPES registry on June 4, 2007.

Where is Sanjay Garg located?

Sanjay Garg practices at 2125 Valleygate Dr Ste 201, Fayetteville, NC 28304. The listed phone number is (910) 920-1450.

What is Sanjay Garg's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Sanjay Garg enrolled in Medicare?

Yes. Sanjay Garg 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 Sanjay Garg accept?

Health plans from AmeriHealth Caritas Next, Blue Cross and Blue Shield of NC and UnitedHealthcare list Sanjay Garg 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 Sanjay Garg affiliated with any hospitals?

According to CMS data, Sanjay Garg is affiliated with Cape Fear Valley Medical Center.

When was this NPI record last updated?

The NPPES record for Sanjay Garg was last updated on February 7, 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.