DR. ROJA RAMANI SANIKAPALLY M.D.
NPI 1942275433
Hospitalist in Athens, GA

Q: What is Roja Sanikapally's NPI number?

The NPI number for Roja Sanikapally is 1942275433. It was assigned to this individual provider in the NPPES registry on February 20, 2006. The provider is also known as Roja Ramani Durgam MD.

Q: What is Roja Sanikapally's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Q: When was this NPI record last updated?

The NPPES record for Roja Sanikapally was last updated on June 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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 February 20, 2006PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

1199 PRINCE AVE, ATHENS, GA 30606(706) 475-5076(706) 475-6676 Get Directions Write a Review

NPPES record last updated: June 18, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 18, 2018, Jun 13, 2018 (2 updates tracked since 2018).

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About Dr. Roja Ramani Sanikapally M.d. NPPES

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

DR. ROJA RAMANI SANIKAPALLY M.D. (NPI 1942275433) is an individual hospitalist provider in Athens, Georgia, licensed in Georgia (055742) and active in the NPI registry since February 2006. She is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and is a graduate of Other (1997).

NPPES Registry Identity

NPI1942275433

Entity TypeIndividualFemale

Primary Taxonomy208M00000X

Provider Legal NameDR. ROJA RAMANI SANIKAPALLYCredential: M.D.

Location Address1199 PRINCE AVEAthens, GA 30606

Mailing Address2727 Paces Ferry Rd Se Ste 1-1100Atlanta, GA 30339-6151 · (706) 475-5076 · Fax (706) 475-6676

Phone(706) 475-5076

Fax(706) 475-6676

Sole ProprietorNo

Medical School CMSOtherGraduated 1997

Enumeration DateFebruary 20, 2006

Last NPPES UpdateJune 18, 20182 updates tracked since enumeration

✔ NPI 1942275433 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

License✔ Licensed in GA · 055742

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedInternal MedicineTaxonomy 207R00000X · License 055742 (GA)

1199 PRINCE AVE, Athens, GA 30606

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Other Names 1

Former Name (1)Roja Ramani Durgam Md

Other Identifiers 7

Other340838GA · Wellcare

OtherP00241606GA · Rr Medicare-grp # Cc4177

Other8940079GA · United Healthcare

Other52703642-002GA · Bcbs

Other10045166GA · Amerigroup

Other7895146GA · Cigna

Medicaid792293772AGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.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. Roja Ramani Sanikapally 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 ID2264489475

PECOS Enrollment IDI20050331000106

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 5

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.

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.

182 services86 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

97 services63 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

70 services70 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.

55 services54 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

16 services16 patients

Hospital Affiliations CMS Care Compare 2

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

Northside Hospital Forsyth

Acute Care Hospitals · Cumming, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110005

Location1200 Northside Forsyth DriveCumming, GA 30041 · Forsyth County

Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110161

Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30606 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

$124.10 typical visit price

range $53.31 – $164.04

Typical copayment $31.02 (range $13.32 – $41.01)

Most-billed visit code 99204

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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.

100/100

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

Scored as part of a group practice

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

15%141 patients1/55-star benchmark: 100%

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

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

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

3 suppliers19 claims19 services$16.04 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 20

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

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