SANJAY AGARWALA MD
NPI 1932179041
Radiology - Diagnostic Radiology in Lexington, KY

Active since January 23, 2006PECOS EnrolledAccepts Medicare Assignment
1221 S BROADWAY, LEXINGTON, KY 40504(859) 258-4181(859) 258-4064 Get Directions Write a Review

NPPES record last updated: July 27, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Sanjay Agarwala Md NPPES

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

SANJAY AGARWALA MD (NPI 1932179041) is an individual diagnostic radiology provider in Lexington, Kentucky, licensed in Kentucky (55429) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with St Luke's The Woodlands Hospital, and is a graduate of Meharry Medical College School Of Medicine (1993).

NPPES Registry Identity

NPI1932179041
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameSANJAY AGARWALACredential: MD
Location Address1221 S BROADWAYLexington, KY 40504-2701
Mailing Address1221 S BroadwayLexington, KY 40504-2701 · (859) 258-4181 · Fax (859) 258-4064
Fax(859) 258-4064
Sole ProprietorNo
Medical School CMSMeharry Medical College School Of MedicineGraduated 1993
Enumeration DateJanuary 23, 2006
Last NPPES UpdateJuly 27, 2021
NPPES CertifiedJuly 27, 2021
NPI 1932179041 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Licenses Licensed in KY · 55429 Licensed in TX · L8258
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
1221 S BROADWAY, Lexington, KY 40504

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

Sanjay Agarwala 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 ID3779513650
PECOS Enrollment IDI20051117000716
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.

Screening 3d breast mammography 77063
Screening 3D breast mammography is a procedure that uses low-dose X-rays to create detailed images of the breast. This allows for early detection of any unusual changes or growths. It's a non-invasive, outpatient procedure that typically takes about 30 minutes.
705 services705 patients
Screening mammography 77067
Screening mammography is a preventative measure that uses low-dose X-rays to take images of the chest area. It's a key tool in early detection of abnormalities, helping to identify issues before they become symptomatic. It is recommended annually for certain age groups.
703 services703 patients
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) G0279
Diagnostic digital breast tomosynthesis is a 3D imaging test that allows doctors to examine your breast tissue layer by layer. It's performed on one or both sides. It helps in detecting abnormalities more accurately. It's often done in addition to other tests.
114 services109 patients
Limited ultrasound scan of 1 breast 76642
A limited ultrasound scan of one breast is a non-invasive imaging test. It uses sound waves to create pictures of the inside of your breast. It helps identify any unusual growths or changes. It's safe, quick, and typically painless.
83 services79 patients
Diagnostic mammography of 1 breast 77065
Diagnostic mammography of 1 breast is a detailed imaging test that allows doctors to closely examine a specific area in the breast. It's often used when a routine screening reveals an abnormality. This test can help identify any unusual changes or issues.
74 services61 patients
Diagnostic mammography of both breasts 77066
Diagnostic mammography involves using special imaging technology to capture detailed images of both breasts. This procedure helps in identifying any unusual changes or abnormalities. It's a crucial step in ensuring breast health and early detection of potential issues.
56 services56 patients

Hospital Affiliations CMS Care Compare 5

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

St Luke's The Woodlands Hospital

Acute Care Hospitals · The Woodlands, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450862
Location17200 St Luke's WayThe Woodlands, TX 77384 · Montgomery County
Emergency services Birthing friendly

St Luke's Sugar Land Hospital

Acute Care Hospitals · Sugar Land, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number670053
Location1317 Lake Pointe ParkwaySugar Land, TX 77478 · Fort Bend County
Emergency services Birthing friendly

Chi St Lukes Lakeside Hospital

Acute Care Hospitals · The Woodlands, TX
OwnershipVoluntary non-profit - Other
CMS Certification Number670059
Location17400 St Lukes WayThe Woodlands, TX 77384 · Montgomery County
Emergency services

St Luke's Hospital At The Vintage

Acute Care Hospitals · Houston, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number670075
Location20171 Chasewood Park DriveHouston, TX 77070 · Harris County
Emergency services

Houston Methodist The Woodlands Hospital

Acute Care Hospitals · The Woodlands, TX
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number670122
Location17201 Interstate 45 SouthThe Woodlands, TX 77385 · Montgomery County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40504 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
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.

Reported Quality Measures

Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques
Percentage of final reports for patients aged 18 years and older undergoing CT with documentation that one or more of the following dose reduction techniques were used: - Automated exposure control - Adjustment of the mA and/or kV according to patient size -…
95%608 patients
Radiology: Reminder System for Screening Mammograms
Percentage of patients undergoing a screening mammogram whose information is entered into a reminder system with a target due date for the next mammogram
100%687 patients
Radiology: Stenosis Measurement in Carotid Imaging Reports
Percentage of final reports for carotid imaging studies (neck magnetic resonance angiography [MRA], neck computed tomography angiography [CTA], neck duplex ultrasound, carotid angiogram) performed that include direct or indirect reference to measurements of…
97%34 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 20

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

Radiology (Body Imaging)
1221 S BROADWAY
LEXINGTON, KY 40504
Nurse Practitioner
1221 S BROADWAY
LEXINGTON, KY 40504
Nurse Practitioner
1221 S BROADWAY
LEXINGTON, KY 40504
Internal Medicine
1221 S BROADWAY
LEXINGTON, KY 40504
Radiology (Diagnostic Radiology)
1221 S BROADWAY
LEXINGTON, KY 40504
Nurse Practitioner (Family)
1221 S BROADWAY
LEXINGTON, KY 40504
Nurse Practitioner
1221 S BROADWAY
LEXINGTON, KY 40504
Emergency Medicine
1221 S BROADWAY
LEXINGTON, KY 40504

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 Sanjay Agarwala's NPI number?

The NPI number for Sanjay Agarwala is 1932179041. It was assigned to this individual provider in the NPPES registry on January 23, 2006.

Where is Sanjay Agarwala located?

Sanjay Agarwala practices at 1221 S Broadway, Lexington, KY 40504. The listed phone number is (859) 258-4181.

What is Sanjay Agarwala's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Sanjay Agarwala enrolled in Medicare?

Yes. Sanjay Agarwala 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 Sanjay Agarwala accept?

Health plans from Blue Cross and Blue Shield of Texas, Community Health Choice, HMO Louisiana, Molina Healthcare and Sendero Health Plans, Local Nonprofit list Sanjay Agarwala 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 Sanjay Agarwala affiliated with any hospitals?

According to CMS data, Sanjay Agarwala is affiliated with St Luke's The Woodlands Hospital, St Luke's Sugar Land Hospital, Chi St Lukes Lakeside Hospital, St Luke's Hospital At The Vintage and Houston Methodist The Woodlands Hospital.

When was this NPI record last updated?

The NPPES record for Sanjay Agarwala was last updated on July 27, 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.