KRISHNA PRIYA RAJU MD
NPI 1922058940
Internal Medicine - Pulmonary Disease in Fort Myers, FL

Active since May 11, 2006PECOS EnrolledAccepts Medicare Assignment
79.77/100
CMS Quality Rating
16420 HEALTHPARK COMMONS DR, FORT MYERS, FL 33908(239) 985-1925(239) 321-6044 Get Directions Write a Review

NPPES record last updated: August 20, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Krishna Priya Raju Md NPPES

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

KRISHNA PRIYA RAJU MD (NPI 1922058940) is an individual pulmonary disease provider in Fort Myers, Florida, licensed in Florida (ME90923) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Lee Memorial Hospital, and is a graduate of Other (1991).

NPPES Registry Identity

NPI1922058940
Entity TypeIndividualFemale
Primary Taxonomy207RP1001X
Provider Legal NameKRISHNA PRIYA RAJUCredential: MD
Location Address16420 HEALTHPARK COMMONS DRFort Myers, FL 33908-9621
Mailing AddressPo Box 2147Fort Myers, FL 33902-2147 · (239) 985-1925 · Fax (239) 321-6044
Fax(239) 321-6044
Sole ProprietorNo
Medical School CMSOtherGraduated 1991
Enumeration DateMay 11, 2006
Last NPPES UpdateAugust 20, 2024
NPPES CertifiedAugust 20, 2024
NPI 1922058940 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License Licensed in FL · ME90923
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
16420 HEALTHPARK COMMONS DR, Fort Myers, FL 33908

Other Identifiers 7

Other304247FL · Avmed
Other7124286FL · Aetna
OtherP01319836FL · Rr Medicare
OtherP108782FL · Freedom
OtherP511755FL · Optimum
Medicaid277153500FL
Other41818Bcbs

Accepted 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

Krishna Priya Raju 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 ID547168668
PECOS Enrollment IDI20060817000355
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 13

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.
734 services464 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.
137 services137 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.
68 services67 patients
Test for exercise-induced lung stress 94618
An exercise-induced lung stress test assesses how your lungs respond to physical activity. During the test, you'll exercise on a treadmill or stationary bike while your heart rate, breathing, blood pressure, and oxygen levels are monitored. This helps identify any abnormal lung responses to exercise.
42 services38 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.
41 services41 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
40 services39 patients

Hospital Affiliations CMS Care Compare 3

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

Lee Memorial Hospital

Acute Care Hospitals · Fort Myers, FL
5/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100012
Location2776 Cleveland AveFort Myers, FL 33901 · Lee County
Emergency services Birthing friendly

Gulf Coast Medical Center Lee Health

Acute Care Hospitals · Fort Myers, FL
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100220
Location13681 Doctors WayFort Myers, FL 33912 · Lee County
Emergency services

Cape Coral Hospital

Acute Care Hospitals · Cape Coral, FL
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100244
Location636 Del Prado BlvdCape Coral, FL 33990 · Lee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33908 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
$135.56 typical visit price
range $58.56 – $179.05
Typical copayment $33.89 (range $14.64 – $44.76)
Most-billed visit code 99204
Established Patient
$103.21 typical visit price
range $18.44 – $144.68
Typical copayment $25.80 (range $4.61 – $36.17)
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.

79.77/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality77.34
Promoting Interoperability100
Improvement Activities40
Cost55.23

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
50%223 patients3/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
52%367 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.
83%1,781 patients3/55-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…
66%716 patients3/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
3%351 patients1/55-star benchmark: 88%
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: 99% · 433 patients
Patients tobacco: 97% · 433 patients
75%32 patients4/55-star benchmark: 98%
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 16

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
5 suppliers20 claims20 services$72.34 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
5 suppliers16 claims44 services$29.59 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
4 suppliers16 claims16 services$14.73 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
5 suppliers18 claims101 services$1.90 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
6 suppliers49 claims56 services$14.18 avg. paid by Medicare
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470
DME-Other DME · category DE001N
3 suppliers13 claims13 services$72.90 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 13

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

Internal Medicine (Pulmonary Disease)
16420 HEALTHPARK COMMONS DR
FORT MYERS, FL 33908
Internal Medicine (Pulmonary Disease)
16420 HEALTHPARK COMMONS DR
FORT MYERS, FL 33908
Nurse Practitioner (Gerontology)
16420 HEALTHPARK COMMONS DR
FORT MYERS, FL 33908
Internal Medicine (Pulmonary Disease)
16420 HEALTHPARK COMMONS DR, SUITE 100
FORT MYERS, FL 33908
Physician Assistant
16420 HEALTHPARK COMMONS DR
FORT MYERS, FL 33908
Internal Medicine (Pulmonary Disease)
16420 HEALTHPARK COMMONS DR
FORT MYERS, FL 33908
Internal Medicine (Pulmonary Disease)
16420 HEALTHPARK COMMONS DR, SUITE 100
FORT MYERS, FL 33908
Physician Assistant
16420 HEALTHPARK COMMONS DR
FORT MYERS, FL 33908

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 Krishna Priya Raju's NPI number?

The NPI number for Krishna Priya Raju is 1922058940. It was assigned to this individual provider in the NPPES registry on May 11, 2006.

Where is Krishna Priya Raju located?

Krishna Priya Raju practices at 16420 Healthpark Commons Dr, Fort Myers, FL 33908. The listed phone number is (239) 985-1925.

What is Krishna Priya Raju's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Krishna Priya Raju enrolled in Medicare?

Yes. Krishna Priya Raju 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 Krishna Priya Raju accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, AvMed and Florida Blue (BlueCross BlueShield FL) and 3 other insurers list Krishna Priya Raju 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 Krishna Priya Raju affiliated with any hospitals?

According to CMS data, Krishna Priya Raju is affiliated with Lee Memorial Hospital, Gulf Coast Medical Center Lee Health and Cape Coral Hospital.

When was this NPI record last updated?

The NPPES record for Krishna Priya Raju was last updated on August 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.