DR. PRACHI U THANAWALA M.D.
NPI 1922368125
Internal Medicine - Cardiovascular Disease in Pennington, NJ

Q: What is Prachi Thanawala's NPI number?

The NPI number for Prachi Thanawala is 1922368125. It was assigned to this individual provider in the NPPES registry on May 22, 2012.

Q: What is Prachi Thanawala's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Q: When was this NPI record last updated?

The NPPES record for Prachi Thanawala was last updated on April 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since May 22, 2012PECOS EnrolledAccepts Medicare Assignment

95.77/100

CMS Quality Rating

2 CAPITAL WAY STE 385, PENNINGTON, NJ 08534(609) 303-4838(609) 303-4835 Get Directions Write a Review

NPPES record last updated: April 30, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 30, 2021, Jul 15, 2019, Oct 16, 2018 (3 updates tracked since 2018).

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About Dr. Prachi U Thanawala M.d. NPPES

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

DR. PRACHI U THANAWALA M.D. (NPI 1922368125) is an individual cardiovascular disease provider in Pennington, New Jersey, licensed in New Jersey (25MA10066400) and active in the NPI registry since May 2012. She is enrolled in Medicare PECOS, is affiliated with Capital Health Medical Center - Hopewell, and maintains a secondary practice location in Newtown.

NPPES Registry Identity

NPI1922368125

Entity TypeIndividualFemale

Primary Taxonomy207RC0000X

Provider Legal NameDR. PRACHI U THANAWALACredential: M.D.

Location Address2 CAPITAL WAY STE 385Pennington, NJ 08534-2521

Mailing Address2 Capital Way, Ste 385Pennington, NJ 08534-2521 · (609) 303-4838 · Fax (609) 303-4835

Phone(609) 303-4838

Fax(609) 303-4835

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateMay 22, 2012

Last NPPES UpdateApril 30, 20213 updates tracked since enumeration

NPPES CertifiedApril 30, 2021

✔ NPI 1922368125 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

Licenses✔ Licensed in NJ · 25MA10066400✔ Licensed in NY · 294406

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

2 CAPITAL WAY STE 385, Pennington, NJ 08534

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Secondary Practice Location 1

Location 13 Penns Trl Fl 2Newtown, PA 18940-1812 · Phone (609) 303-4838 · Fax (609) 303-4835

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.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. Prachi U Thanawala 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 ID7012132327

PECOS Enrollment IDI20190807001339, I20200330003658

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 16

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.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

464 services371 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

220 services165 patients

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.

206 services129 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

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.

175 services173 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

69 services67 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

64 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.

39 services39 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.

38 services31 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

31 services31 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

31 services31 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

29 services29 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

26 services26 patients

Ultrasound of heart blood flow, valves and chambers 93320

An ultrasound of your heart, also known as an echocardiogram, is a test that uses sound waves to create detailed images of your heart. It helps doctors check the health of your heart's chambers, valves, and blood flow.

19 services19 patients

Ultrasound of heart with color-depicted blood flow, rate and valve function 93325

An ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.

19 services19 patients

Ultrasound of heart with probe in esophagus, with report 93312

This procedure, called a transesophageal echocardiogram, uses a small probe passed into your esophagus to capture detailed images of your heart. The report provides information about your heart's structure and function.

18 services18 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Capital Health Medical Center - Hopewell

Acute Care Hospitals · Pennington, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310044

LocationOne Capital WayPennington, NJ 08534 · Mercer County

Emergency services Birthing friendly

Capital Health Regional Medical Center

Acute Care Hospitals · Trenton, NJ

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310092

Location750 Brunswick AveTrenton, NJ 08638 · Mercer County

Emergency services

St Mary Medical Center

Acute Care Hospitals · Langhorne, PA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390258

LocationLanghorne-Newtown RdLanghorne, PA 19047 · Bucks County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08534 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

$140.34 typical visit price

range $61.59 – $185.05

Typical copayment $35.08 (range $15.39 – $46.26)

Most-billed visit code 99204

Established Patient

$76.45 typical visit price

range $20.08 – $150.98

Typical copayment $19.11 (range $5.02 – $37.74)

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.

95.77/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

76.75

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Breast Cancer Screening

60%281 patients3/55-star benchmark: 93%

Cervical Cancer Screening

52%334 patients3/55-star benchmark: 98%

Colorectal Cancer Screening

56%630 patients3/55-star benchmark: 88%

Controlling High Blood Pressure

72%545 patients4/55-star benchmark: 91%

Coronary Artery Disease (CAD): Beta-Blocker Therapy Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF <= 40%)

97%31 patients4/55-star benchmark: 99%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

40%177 patients3/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

84%2,137 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

85%342 patients4/55-star benchmark: 100%

HIV Screening

28%690 patients2/55-star benchmark: 60%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

51%948 patients3/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

80%800 patients4/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

39%636 patients3/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 90% · 903 patients

Patients screened: 94% · 903 patients

67%100 patients3/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

92%490 patients5/55-star benchmark: 91%

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 14

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

NEIL SAXENA MD

Internal Medicine (Cardiovascular Disease)