SOUMYA PAI
NPI 1902107840
Surgery in Fresno, CA
Active since November 09, 2010PECOS EnrolledAccepts Medicare Assignment
72.8/100
CMS Quality Rating
1105 E SPRUCE AVE, SUITE 201, FRESNO, CA 93720(559) 450-7200(559) 450-7214 Get Directions Write a Review
About Soumya Pai NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUMYA PAI (NPI 1902107840) is an individual surgery provider in Fresno, California, licensed in California (A118125) and active in the NPI registry since November 2010. She is enrolled in Medicare PECOS and is a graduate of Other (1999).
NPPES Registry Identity
NPI1902107840
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameSOUMYA PAI
Location Address1105 E SPRUCE AVE, SUITE 201Fresno, CA 93720-3313
Mailing Address1105 E Spruce Ave, Suite 201Fresno, CA 93720-3313 · (559) 450-7200 · Fax (559) 450-7214
Phone(559) 450-7200
Fax(559) 450-7214
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateNovember 9, 2010
Last NPPES UpdateDecember 12, 2016
✔ NPI 1902107840 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 2
★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in CA · A118125
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1105 E SPRUCE AVE, Fresno, CA 93720
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
Soumya Pai 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 ID7214231786
PECOS Enrollment IDI20160203000635
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 9
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.
123 services111 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.
81 services63 patients
Repair of wound by transferring skin, 30.1-60.0 sq cm 14301
This procedure involves repairing a wound by moving healthy skin from one area of the body to the wound site. The transferred skin, measuring between 30.1-60.0 square cm, aids in healing and reduces scarring.
39 services37 patients
Partial removal of breast 19301
A partial removal of the breast, also known as a lumpectomy, involves taking out a portion of the breast tissue to eliminate concerning cells. It's typically performed when the problem area is limited in size. This procedure helps to preserve most of the breast's appearance while aiming to remove all the unhealthy cells.
37 services35 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.
37 services33 patients
Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212
This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.
29 services24 patients
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 93720 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
$90.32 typical visit price
range $58.87 – $176.60
Typical copayment $22.58 (range $14.71 – $44.15)
Most-billed visit code 99203
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
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.
72.8/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practiceQuality
74.33
Promoting Interoperability
100
Improvement Activities
40
Cost
24.26
Reported Quality Measures
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
38%64 patients2/55-star benchmark: 92%
Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
33%112 patients2/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
45%106 patients3/55-star benchmark: 85%
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%601 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.
92%144 patients3/55-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.
100%209 patients5/55-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.
77%296 patients4/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
17%65 patients1/55-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…
80%205 patients4/55-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: 100% · 114 patients
96%72 patients4/55-star benchmark: 98%
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
53%72 patients3/55-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…
99%296 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…
12%296 patients1/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 64 patients
0%64 patients5/55-star benchmark: 100%
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.
28%296 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 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Clinic/Center (Ambulatory Surgical)
1105 E SPRUCE AVE, SUITE 100
FRESNO, CA 93720
FRESNO, CA 93720
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 Soumya Pai's NPI number?
The NPI number for Soumya Pai is 1902107840. It was assigned to this individual provider in the NPPES registry on November 9, 2010.
Where is Soumya Pai located?
Soumya Pai practices at 1105 E Spruce Ave Suite 201, Fresno, CA 93720. The listed phone number is (559) 450-7200.
What is Soumya Pai's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is Soumya Pai enrolled in Medicare?
Yes. Soumya Pai 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 Soumya Pai was last updated on December 12, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Soumya Pai · NPI 1902107840
Surgery physician in Fresno, California. Individual provider, active in the CMS NPPES registry since November 9, 2010.
## Identity
- **NPI:** 1902107840 (Entity type: Individual)
- **Enumerated:** November 9, 2010
- **Primary specialty:** Surgery · taxonomy 208600000X
- **State license:** A118125 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 1105 E SPRUCE AVE, SUITE 201, Fresno, CA 93720-3313
- **Phone:** (559) 450-7200 · **Fax:** (559) 450-7214
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 1999
## Record status
- **NPPES last updated:** December 12, 2016
---
Source: [NPI Profile](https://npiprofile.com/npi/1902107840) · Data from the CMS NPPES public registry.