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DR. SANJAY K NIGAM MD
NPI 1942278973
Psychiatry & Neurology - Psychiatry in Maryville, IL

Active since March 08, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
6805 STATE ROUTE 162, STE 201, MARYVILLE, IL 62062(618) 288-5019(618) 288-5059 Get Directions Write a Review

NPPES record last updated: December 27, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 27, 2021, May 12, 2021, Mar 27, 2018 (3 updates tracked since 2018).

About Dr. Sanjay K Nigam Md NPPES

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

DR. SANJAY K NIGAM MD (NPI 1942278973) is an individual psychiatry provider in Maryville, Illinois, licensed in Illinois (036107024) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Memorial Hospital, and maintains a secondary practice location in Maryville.

NPPES Registry Identity

NPI1942278973
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameDR. SANJAY K NIGAMCredential: MD
Location Address6805 STATE ROUTE 162, STE 201Maryville, IL 62062-8530
Mailing Address6805 State Route 162 Ste 201Maryville, IL 62062-8530 · (618) 288-5019 · Fax (618) 288-5059
Phone(618) 288-5019
Fax(618) 288-5059
Sole ProprietorYes
Medical School CMSOtherGraduated 1990
Enumeration DateMarch 8, 2006
Last NPPES UpdateDecember 27, 20213 updates tracked since enumeration
NPPES CertifiedDecember 27, 2021
✔ NPI 1942278973 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in IL · 036107024
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
6805 STATE ROUTE 162, Maryville, IL 62062
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Secondary Practice Location 1

Location 16805 State Route 162 Ste 201Maryville, IL 62062-8530 · Phone (618) 288-5019 · Fax (618) 288-5059

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.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. Sanjay K Nigam 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 ID1658362504
PECOS Enrollment IDI20040520000394
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.

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.
256 services80 patients
Assessment of emotional or behavioral problems 96127
Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.
122 services58 patients
Psychiatric diagnostic evaluation with medical services 90792
A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
41 services41 patients
Testing for presence of drug, read by direct observation 80305
Testing for the presence of drugs involves collecting a sample, usually urine, which is then analyzed for specific substances. The process is monitored directly to ensure accuracy and integrity. This test helps to confirm if drugs are present in your system.
33 services26 patients
Psychotherapy with evaluation and management visit, 30 minutes 90833
Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.
28 services20 patients

Hospital Affiliations CMS Care Compare

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

Memorial Hospital

Acute Care Hospitals · Belleville, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140185
Location4500 Memorial DriveBelleville, IL 62226 · St. Clair County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62062 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
$173.35 typical visit price
range $56.28 – $173.35
Typical copayment $43.33 (range $14.07 – $43.33)
Most-billed visit code 99205
Established Patient
$70.42 typical visit price
range $17.51 – $139.99
Typical copayment $17.60 (range $4.37 – $34.99)
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality87.46
Promoting Interoperability100
Improvement Activities40
Cost98.59

Reported Quality Measures

Adult Major Depressive Disorder (MDD): Suicide Risk Assessment
36%657 patients
Cervical Cancer Screening
60%434 patients3/55-star benchmark: 98%
Closing the Referral Loop: Receipt of Specialist Report
6%52 patients1/55-star benchmark: 87%
Colorectal Cancer Screening
55%554 patients3/55-star benchmark: 88%
Controlling High Blood Pressure
65%100 patients3/55-star benchmark: 91%
Dementia: Cognitive Assessment
46%26 patients
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
98%53 patients1/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
93%4,498 patients4/55-star benchmark: 100%
e-Prescribing
96%1,372 patients3/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
37%238 patients2/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
68%324 patients3/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 77% · 1,274 patients
Patients screened: 84% · 1,274 patients
62%239 patients3/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
90%567 patients4/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
78%69 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 36% · 187 patients
Patients totalRate: 33% · 252 patients
16%252 patients3/55-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.

Other Providers at the Same Location NPPES 2

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

PSYCHIATRIC URGENT CARE LLC
Clinic/Center (Urgent Care)
6805 STATE ROUTE 162
MARYVILLE, IL 62062
Madison County (618) 288-5019
ANTONIO TERELL THOMAS PMNHP
Nurse Practitioner (Psychiatric/Mental Health)
6805 STATE ROUTE 162
MARYVILLE, IL 62062
Madison County (618) 288-5019

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 Nigam's NPI number?

The NPI number for Sanjay Nigam is 1942278973. It was assigned to this individual provider in the NPPES registry on March 8, 2006.

Where is Sanjay Nigam located?

Sanjay Nigam practices at 6805 State Route 162 Ste 201, Maryville, IL 62062. The listed phone number is (618) 288-5019.

What is Sanjay Nigam's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Sanjay Nigam enrolled in Medicare?

Yes. Sanjay Nigam 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 Nigam accept?

Health plans from Providence Health Plan list Sanjay Nigam 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 Nigam affiliated with any hospitals?

According to CMS data, Sanjay Nigam is affiliated with Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Sanjay Nigam was last updated on December 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.