DR. VISHAL BHALANI M.D.
NPI 1902025596
Urology in Cumming, GA

Q: What is Vishal Bhalani's NPI number?

The NPI number for Vishal Bhalani is 1902025596. It was assigned to this individual provider in the NPPES registry on April 24, 2007.

Q: What is Vishal Bhalani's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Vishal Bhalani was last updated on July 25, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 24, 2007PECOS EnrolledAccepts Medicare Assignment

960 SANDERS RD STE 500, CUMMING, GA 30041(678) 321-7227 Get Directions Write a Review

NPPES record last updated: July 25, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 25, 2023, Nov 30, 2015 (2 updates tracked since 2015).

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About Dr. Vishal Bhalani M.d. NPPES

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

DR. VISHAL BHALANI M.D. (NPI 1902025596) is an individual urology provider in Cumming, Georgia, licensed in Georgia (074749) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and is a graduate of University Of Miami, Lm Miller School Of Medicine (2006).

NPPES Registry Identity

NPI1902025596

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameDR. VISHAL BHALANICredential: M.D.

Location Address960 SANDERS RD STE 500Cumming, GA 30041-5978

Mailing Address960 Sanders Rd Ste 500Cumming, GA 30041-5978 · (678) 321-7227

Phone(678) 321-7227

Sole ProprietorYes

Medical School CMSUniversity Of Miami, Lm Miller School Of MedicineGraduated 2006

Enumeration DateApril 24, 2007

Last NPPES UpdateJuly 25, 20232 updates tracked since enumeration

NPPES CertifiedJuly 25, 2023

✔ NPI 1902025596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

Licenses✔ Licensed in GA · 074749✔ Licensed in IL · 125053804

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

960 SANDERS RD STE 500, Cumming, GA 30041

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.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. Vishal Bhalani 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 ID2365698347

PECOS Enrollment IDI20151005002058

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 15

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.

303 services186 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

294 services241 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

228 services143 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.

207 services207 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.

119 services94 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

85 services82 patients

Insertion of implant in urethra within prostate gland using an endoscope, each additional implant 52442

This procedure involves placing additional tiny implants in the prostate gland using a special viewing device. It's a common method to address certain health concerns. The process is done carefully to ensure minimal discomfort.

80 services23 patients

Electronic assessment of bladder emptying 51741

Electronic assessment of bladder emptying is a non-invasive test that measures how well your bladder functions. It uses ultrasound technology to create images of your bladder before and after you use the restroom, helping to identify any issues with bladder emptying.

69 services55 patients

Ultrasound scan of pelvic region through rectum 76872

An ultrasound scan of the pelvic region through the rectum is a medical procedure where a small, smooth device is gently inserted into the rectum. This device uses sound waves to create images of the internal structures in the lower abdomen, aiding in diagnosis and treatment planning.

53 services53 patients

Complete ultrasound scan behind abdominal cavity 76770

A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.

33 services29 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

23 services22 patients

Insertion of implant in urethra within prostate gland using an endoscope, 1 implant 52441

This procedure involves placing a small device in the urinary tract using a scope. The device is placed within the prostate gland, which helps manage urinary flow. It's a minimally invasive procedure that aids in improving your comfort and health.

23 services23 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.

22 services22 patients

Biopsy of prostate gland 55700

A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.

18 services18 patients

Simple bladder irrigation and/or instillation 51700

Bladder irrigation and/or instillation is a process where a sterile solution is introduced into the bladder to cleanse it or deliver medication. This procedure helps manage certain bladder conditions, ensuring optimal bladder health.

13 services11 patients

Hospital Affiliations CMS Care Compare 4

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

Northside Hospital Forsyth

Acute Care Hospitals · Cumming, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110005

Location1200 Northside Forsyth DriveCumming, GA 30041 · Forsyth County

Birthing friendly

Northside Hospital Gwinnett

Acute Care Hospitals · Lawrenceville, GA

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110087

Location1000 Medical Center BoulevardLawrenceville, GA 30046 · Gwinnett County

Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110161

Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County

Birthing friendly

Northside Hospital Duluth

Acute Care Hospitals · Duluth, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110252

Location3620 Howell Ferry RoadDuluth, GA 30096 · Gwinnett County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30041 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

$130.64 typical visit price

range $56.84 – $172.43

Typical copayment $32.66 (range $14.21 – $43.10)

Most-billed visit code 99204

Established Patient

$70.85 typical visit price

range $18.22 – $140.40

Typical copayment $17.71 (range $4.55 – $35.10)

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.

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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.

CHRISTINA KUMARY BHATIA MSN, APRN FNP-C

Nurse Practitioner (Family)

960 SANDERS RD STE 500
CUMMING, GA 30041

Forsyth County (678) 321-7227

THE BHALANI UROLOGY INSTITUTE LLC

Urology

960 SANDERS RD STE 500
CUMMING, GA 30041

Forsyth County (312) 576-4598

BHALANI UROLOGY SURGERY LLC

Clinic/Center (Ambulatory Surgical)

960 SANDERS RD STE 500
CUMMING, GA 30041

Forsyth County (678) 321-7227

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 Vishal Bhalani's NPI number?

The NPI number for Vishal Bhalani is 1902025596. It was assigned to this individual provider in the NPPES registry on April 24, 2007.

Where is Vishal Bhalani located?

Vishal Bhalani practices at 960 Sanders Rd Ste 500, Cumming, GA 30041. The listed phone number is (678) 321-7227.

What is Vishal Bhalani's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Vishal Bhalani enrolled in Medicare?

Yes. Vishal Bhalani 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 Vishal Bhalani accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Vishal Bhalani 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 Vishal Bhalani affiliated with any hospitals?

According to CMS data, Vishal Bhalani is affiliated with Northside Hospital Forsyth, Northside Hospital Gwinnett, Northside Hospital and Northside Hospital Duluth.

When was this NPI record last updated?

The NPPES record for Vishal Bhalani was last updated on July 25, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.