DR. GOLALI NEJATI M.D NPI 1922231604
Internal Medicine in Ossining, NY

About DR. GOLALI NEJATI M.D

Golali Nejati is an internist established in Ossining, New York and his medical specialization is Internal Medicine with more than 31 years of experience. The NPI number of Golali Nejati is 1922231604 and was assigned on August 2009. The practitioner's primary taxonomy code is 207R00000X with license number 254652 (NY). The provider is registered as an individual and his NPI record was last updated 12 years ago. Golali Nejati operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization.

NPI
1922231604
Provider NameDR. GOLALI NEJATI M.D
Location Address14 CHURCH ST OSSINING, NY 10562
Location Phone(914) 923-9414
Mailing Address14 CHURCH ST OSSINING, NY 10562
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1992
Is Sole Proprietor?Yes
Enumeration Date08-28-2009
Last Update Date08-16-2010

An internist like Dr. Golali Nejati M.d 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.Golali Nejati 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.

Golali Nejati is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider has performance information for Merit-Based Incentive Payment System (MIPS) Quality, Promoting Interoperability, and Improvement Activities in the following quality measures: breast cancer screening, chronic care and preventative care management for empaneled patients, colorectal cancer screening, diabetes: eye exam, diabetes: medical attention for nephropathy, engagement of patients through implementation of improvements in patient portal, e-prescribing, implementation of documentation improvements for practice/process improvements, pneumococcal vaccination status for older adults, provide 24/7 access to mips eligible clinicians or groups who have real-time access to patient's medical record, provide patients electronic access to their health information, security risk analysis and use of decision support and standardized treatment protocols. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The typical physician office visit costs for Medicare beneficiaries in this area are: $40.72 for a new patient copayment and $31.16 for an established patient copayment.



Primary Taxonomy

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Taxonomy Code207R00000X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
License No.254652
License StateNY
Taxonomy DescriptionA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting insurance plans from the following companies or healthcare programs:

  • Medicaid
  • Medicare

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Business Address

DR. GOLALI NEJATI M.D
14 CHURCH ST
OSSINING, NY
ZIP 10562
Phone: (914) 923-9414
Fax: (914) 923-9412

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Mailing Address

DR. GOLALI NEJATI M.D
14 CHURCH ST
OSSINING, NY
ZIP 10562
Phone: (914) 923-9414
Fax: (914) 923-9412


Location Map

PECOS Enrollment and Medicare Participation Status

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID4082760863
PECOS Enrollment IDI20090919000047
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 10562 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$71.49 $215.02 $162.91
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$17.87 $53.75 $40.72
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$22.05 $174.06 $124.65
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$5.51 $43.51 $31.16

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

MIPS Quality Measures

The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.

Quality Measure Performance Number of Patients
Breast Cancer Screening 0% 227
Percentage of women 50 - 74 years of age who had a mammogram to screen for breast cancer in the 27 months prior to the end of the measurement period.
Chronic Care and Preventative Care Management for Empaneled PatientsYesN/A
In order to receive credit for this activity, a MIPS eligible clinician must manage chronic and preventive care for empaneled patients (that is, patients assigned to care teams for the purpose of population health management), which could include one or more of the following actions:- Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions;- Use evidence based, condition-specific pathways for care of chronic conditions (for example, hypertension, diabetes, depression, asthma, and heart failure). These might include, but are not limited to, the NCQA Diabetes Recognition Program (DRP) and the NCQA Heart/Stroke Recognition Program (HSRP);- Use pre-visit planning, that is, preparations for conversations or actions to propose with patient before an in-office visit to optimize preventive care and team management of patients with chronic conditions;- Use panel support tools, (that is, registry functionality) or other technology that can use clinical data to identify trends or data points in patient records to identify services due;- Use predictive analytical models to predict risk, onset and progression of chronic diseases; and/orUse reminders and outreach (e.g., phone calls, emails, postcards, patient portals, and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
Colorectal Cancer Screening 6% 410
Percentage of patients 50-75 years of age who had appropriate screening for colorectal cancer.
Diabetes: Eye Exam 0% 181
Percentage of patients 18-75 years of age with diabetes and an active diagnosis of retinopathy overlapping the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or diabetics with no diagnosis of retinopathy overlapping the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or in the 12 months prior to the measurement period.
Diabetes: Medical Attention for Nephropathy 43% 181
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period.
Engagement of patients through implementation of improvements in patient portalYesN/A
Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence.
e-Prescribing 100% 1352
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using CEHRT.
Implementation of documentation improvements for practice/process improvementsYesN/A
Implementation of practices/processes that document care coordination activities (e.g., a documented care coordination encounter that tracks all clinical staff involved and communications from date patient is scheduled for outpatient procedure through day of procedure).
Pneumococcal Vaccination Status for Older Adults 23% 255
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine.
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical RecordYesN/A
- Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following:- Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care);- Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/orProvision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.
Provide Patients Electronic Access to Their Health Information 29% 396
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient-authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified electronic health record technology (CEHRT).
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified electronic health record technology (CEHRT) in accordance with requirements in 45 CFR 164.312(a)(2)(iv) and 164.306(d)(3), implement security updates as necessary, and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Use of decision support and standardized treatment protocolsYesN/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 14Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • 13Routine EKG using at least 12 leads including interpretation and report (HCPCS:93000)

Group Taxonomy


193200000X MULTI-SPECIALTY GROUP - This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
03158454MEDICAID (05)NY
A400018419MEDICARE PIN (08)
1922231604OTHER (01)NPI

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1922231604
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
294243260
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 4 + 2 + 4 + 3 + 2 + 6 + 0 + 24 = 56
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 56 = 44

The NPI number 1922231604 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 6 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1124005087 MICHAEL EDWARD LECHNER MD
Individual
General Practice14 CHURCH ST
OSSINING, NY 10562
(914) 762-0722
1851370001DR. CHRISTY E JOYCE M.D.
Individual
Internal Medicine14 CHURCH ST SUITE 208
OSSINING, NY 10562
(914) 941-1334
1568556645NORTH STAR MEDICAL GROUP, P.C.
Organization
Family Medicine14 CHURCH ST SUITE 208
OSSINING, NY 10562
(914) 923-9415
1407916497DR. ALAN A COHEN DMD
Individual
Dentist (Oral and Maxillofacial Surgery)14 CHURCH ST
OSSINING, NY 10562
(914) 762-3400
1306825559DR. MARY J WOLFE M.D.
Individual
Internal Medicine14 CHURCH ST SUITE 208
OSSINING, NY 10562
(914) 941-1334
1013077486 BINDU N MATHEW MD
Individual
Internal Medicine14 CHURCH ST SUITE 200
OSSINING, NY 10562
(914) 923-9415

Frequently Asked Questions

What is Dr. Golali Nejati M.D NPI number?

The NPI number assigned to Dr. Golali Nejati M.D is 1922231604, registered as an "individual" on August 28, 2009

Where is Dr. Golali Nejati M.D located?

The provider is located at 14 Church St Ossining, Ny 10562 and the phone number is (914) 923-9414

Which is Dr. Golali Nejati M.D specialty?

The provider's speciality is Internal Medicine

How many years of experience does Dr. Golali Nejati M.D have?

The provider has more than 31 years of experience.

What insurance does Dr. Golali Nejati M.D accept?

The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your insurance plan is currently accepted.

Is Dr. Golali Nejati M.D registered in PECOS?

Yes, as of January 10, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary 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 are Dr. Golali Nejati M.D Quality Ratings?

The provider obtained a high score in the following performance measures: e-Prescribing. The quality ratings are based on unbiased reviews and reported submissions to Medicare's Quality Payment Program.

How much is a visit to Dr. Golali Nejati M.D?

Medicare beneficiaries should expect a typical cost of $162.91 with an average copayment of $40.72 for new patient appointments. Established patients should expect a typical charge of $124.65 and an average copayment of 31.16. Please review your insurance plan or contact the provider directly to determine your specific costs.

What are some of the services provided by Dr. Golali Nejati M.D?

The most common procedures or services performed by this practitioner are: Insertion of needle into vein for collection of blood sample and Routine EKG using at least 12 leads including interpretation and report.

How do I update my NPI information?

The NPI record of Dr. Golali Nejati M.D was last updated on August 28, 2009. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]