SANJAY PRASHER MD
NPI 1922009935
Internal Medicine - Clinical Cardiac Electrophysiology in Fayetteville, NC
NPI Status: Active since August 02, 2005
Contact Information
2301 ROBESON ST
SUITE 301
FAYETTEVILLE, NC
ZIP 28305
Phone: (910) 484-4100
Fax: (910) 484-4179
- Individual
- Male
- Internal Medicine
- Clinical Cardiac Electrophysiology
- Accepts Insurance
- PECOS Enrolled
- Medicare Quality Reporting
About SANJAY PRASHER
This page provides the complete NPI Profile along with additional information for Sanjay Prasher, an internist established in Fayetteville, North Carolina with a medical specialization in Internal Medicine, focusing in clinical cardiac electrophysiology . The healthcare provider is registered in the NPI registry with number 1922009935 assigned on August 2005. The practitioner's primary taxonomy code is 207RC0001X with license number 200301160 (NC). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1922009935
- Provider Name
- SANJAY PRASHER MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2301 ROBESON ST SUITE 301 FAYETTEVILLE, NC 28305
- Location Phone
- (910) 484-4100
- Location Fax
- (910) 484-4179
- Mailing Address
- 2301 ROBESON ST SUITE 301 FAYETTEVILLE, NC 28305
- Mailing Phone
- (910) 484-4100
- Mailing Fax
- (910) 484-4179
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-02-2005
- Last Update Date
- 01-28-2011
- Code Navigator
An internist like Sanjay Prasher is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Clinical Cardiac Electrophysiology
- Taxonomy Code
- 207RC0001X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 200301160
- License State
- NC
- Taxonomy Description
- A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Bronze HSA Eligible | Integrated | Nationwide Doctors - PPO
- Blue Advantage Bronze Standard | Nationwide Doctors - PPO
- Blue Advantage Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Gold Standard A | Nationwide Doctors - PPO
- Blue Advantage Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Silver Standard | Nationwide Doctors - PPO
- Blue Care Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Statewide Doctors - HMO
- Blue Care Bronze Complete | $60 PCP | $20 Tier 1 Rx | Statewide Doctors - HMO
- Blue Care Bronze HSA Eligible | Integrated | Statewide Doctors - HMO
- Blue Care Bronze Standard | Statewide Doctors - HMO
- Blue Care Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Statewide Doctors - HMO
- Blue Care Gold Standard A | Statewide Doctors - HMO
- Blue Care Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Statewide Doctors - HMO
- Blue Care Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Statewide Doctors - HMO
- Blue Care Silver Standard | Statewide Doctors - HMO
- Blue Home Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | with Novant Health - EPO
- Blue Home Bronze Standard | with Novant Health - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| F90702 | MEDICARE UPIN (02) | NC | |
| P00074543 | OTHER (01) | NC | RAIL ROAD MEDICARE |
| 89135R3 | MEDICAID (05) | NC | |
| 2022837 | MEDICARE PIN (08) | NC |
Medicare Participation & PECOS Enrollment Status
Sanjay Prasher is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
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.
This service was performed 16 times for 16 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 28305 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $125.01
- Minimum New Patient Price $54.12
- Maximum New Patient Price $165.09
- Average New Patient Copayment $31.25
- Minimum New Patient Copayment $13.53
- Maximum New Patient Copayment $41.27
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $95.94
- Minimum Established Patient Price $17.21
- Maximum Established Patient Price $134.61
- Average Established Patient Copayment $23.98
- Minimum Established Patient Copayment $4.3
- Maximum Established Patient Copayment $33.65
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Engagement of New Medicaid Patients and Follow-up | Yes | N/A |
| Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity. | ||
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1922009935, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
FAYETTEVILLE, NC 28305
FAYETTEVILLE, NC 28305
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1922009935, enumerated as an "individual" on August 02, 2005.
The provider is located at 2301 ROBESON ST SUITE 301 FAYETTEVILLE, NC 28305 and the phone number is (910) 484-4100.
Internal Medicine with taxonomy code 207RC0001X and a focus in Clinical Cardiac Electrophysiology.
The provider might be accepting Accepts: Blue Cross and Blue Shield of NC, Medicare and. Please consult your insurance carrier or call the provider to verify.
