PRIYANKA VICHARE
NPI 1952806051
Internal Medicine in Cheverly, MD


Quality Rating: 100 out of 100 score

NPI Status: Active since March 29, 2018

Contact Information

3001 HOSPITAL DR
CHEVERLY, MD
ZIP 20785
Phone: (301) 618-2273

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  • Individual
  • Female
  • Years of Experience 8
  • Internal Medicine
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About PRIYANKA VICHARE

This page provides the complete NPI Profile along with additional information for Priyanka Vichare, an internist established in Cheverly, Maryland with a medical specialization in Internal Medicine and more than 8 years of experience. The healthcare provider is registered in the NPI registry with number 1952806051 assigned on March 2018. The practitioner's primary taxonomy code is 207R00000X with license number 0101272156 (VA). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI
1952806051
Provider Name
PRIYANKA VICHARE
Gender
Female
Entity Type
Individual
Location Address
3001 HOSPITAL DR CHEVERLY, MD 20785
Location Phone
(301) 618-2273
Mailing Address
3001 HOSPITAL DR CHEVERLY, MD 20785
Mailing Phone
(301) 618-3772
Medical School Name
OTHER
Graduation Year
2018
Is Sole Proprietor?
No
Enumeration Date
03-29-2018
Last Update Date
10-19-2021
Code Navigator

An internist like Priyanka Vichare 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.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
0101272156
License State
VA
Taxonomy Description
A 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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1390200000XStudent, Health Care

Student in an Organized Health Care Education/Training Program

 

Medicare Participation & PECOS Enrollment Status

Priyanka Vichare is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Priyanka Vichare 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.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 9830587617

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20211027002480

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • 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 to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Hospital Beds (DB000N)

    Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)

    2 DME suppliers used 23 Medicare Claims 23 Services Paid

  • DME-Oxygen and Supplies (DC000N)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    4 DME suppliers used 48 Medicare Claims 50 Services Paid

  • DME-Other DME (DE000N)

    Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) (HCPCS:E0630)

    1 DME suppliers used 11 Medicare Claims 11 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    4 DME suppliers used 46 Medicare Claims 48 Services Paid

  • DME-Wheelchairs (DD000N)

    Standard wheelchair (HCPCS:K0001)

    1 DME suppliers used 12 Medicare Claims 12 Services Paid

  • DME-Wheelchairs (DD021N)

    Elevating leg rests, pair (for use with capped rental wheelchair base) (HCPCS:K0195)

    1 DME suppliers used 12 Medicare Claims 12 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Advance care planning, first 30 minutes

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

This service was performed 99 times for 92 patients

Follow-up hospital inpatient care per day, typically 15 minutes

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

This service was performed 29 times for 22 patients

Follow-up hospital inpatient care per day, typically 25 minutes

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.

This service was performed 282 times for 177 patients

Follow-up hospital inpatient care per day, typically 35 minutes

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.

This service was performed 215 times for 138 patients

Follow-up nursing facility visit per day, typically 25 minutes

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

This service was performed 23 times for 19 patients

Follow-up observation care per day, typically 25 minutes

Follow-up observation care is a daily service where your health progress is monitored for about 25 minutes. It's a routine check to ensure your treatment is effective and to adjust if necessary. It's a crucial part of your healthcare journey.

This service was performed 19 times for 16 patients

Hospital discharge day management, more than 30 minutes

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.

This service was performed 188 times for 169 patients

Hospital observation care on day of discharge

Hospital observation care on the day of discharge involves monitoring your health status to ensure stability before you leave. This includes assessing vital signs, response to treatment, and readiness for home care or rehabilitation.

This service was performed 46 times for 46 patients

Initial hospital inpatient care per day, typically 70 minutes

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.

This service was performed 68 times for 67 patients

Initial hospital observation care per day, typically 50 minutes

Initial hospital observation care is a service where healthcare professionals monitor your health for about 50 minutes daily. This helps them understand your condition better, plan treatment, and ensure your safety. It's a routine part of hospital care.

This service was performed 18 times for 18 patients

Initial hospital observation care per day, typically 70 minutes

This service involves a healthcare professional closely monitoring your health condition during your hospital stay. It typically lasts for about 70 minutes each day. This helps in timely detection of any changes in your health, allowing for immediate response and treatment.

This service was performed 30 times for 28 patients

Initial nursing facility visit per day, typically 35 minutes

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

This service was performed 16 times for 16 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

This service was performed 21 times for 20 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $36.96 for a new patient copayment and $28.43 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 20785 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $147.85
  • Minimum New Patient Price $65.18
  • Maximum New Patient Price $194.86
  • Average New Patient Copayment $36.96
  • Minimum New Patient Copayment $16.29
  • Maximum New Patient Copayment $48.71

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $113.72
  • Minimum Established Patient Price $21.4
  • Maximum Established Patient Price $158.88
  • Average Established Patient Copayment $28.43
  • Minimum Established Patient Copayment $5.35
  • Maximum Established Patient Copayment $39.72

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

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 100, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 100 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 100

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 100

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Priyanka Vichare is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
WINCHESTER MEDICAL CENTER1840 AMHERST ST
WINCHESTER, VA 22601
(540) 536-8000Acute Care Hospitals
SHENANDOAH MEMORIAL HOSPITAL759 SOUTH MAIN STREET
WOODSTOCK, VA 22664
(540) 459-1100Critical Access Hospitals

Reviews for PRIYANKA VICHARE

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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.
1952806051
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2910216012010
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 1 + 0 + 2 + 1 + 6 + 0 + 1 + 2 + 0 + 1 + 0 + 24 = 49
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 49 = 11

The NPI number 1952806051 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

DR. KIMBERLY VALENTI MD, PHD

Internal Medicine

3001 HOSPITAL DR
CHEVERLY, MD
ZIP 20785

(301) 618-3772

HEE H LEE MD

Radiology

(Diagnostic Radiology)

3001 HOSPITAL DR
CHEVERLY, MD
ZIP 20785

(301) 618-3340

JUNG H LEE MD

Radiology

(Diagnostic Radiology)

3001 HOSPITAL DR
CHEVERLY, MD
ZIP 20785

(301) 618-3340

MEHNUR ABEDIN M.D.

Pediatrics

(Neonatal-Perinatal Medicine)

3001 HOSPITAL DR
CHEVERLY, MD
ZIP 20785

(301) 618-3280

DR. ANTOINE KOFI FOMUFOD M.D.

Pediatrics

(Neonatal-Perinatal Medicine)

3001 HOSPITAL DR
PEDIATRIX MEDICAL GROUP
CHEVERLY, MD
ZIP 20785

(301) 618-2630

DR. ISABELITA G. FRATTAROLA M.D.

Pediatrics

(Neonatal-Perinatal Medicine)

3001 HOSPITAL DR
CHEVERLY, MD
ZIP 20785

(301) 618-3280

DARRYL ATWELL M.D.

Anesthesiology

3001 HOSPITAL DR
CHEVERLY, MD
ZIP 20785

(301) 618-6100

LEEROY MARK CLARKE M.D.

Anesthesiology

3001 HOSPITAL DR
CHEVERLY, MD
ZIP 20785

(301) 618-6100

GARY J HEALY M.D.

Anesthesiology

3001 HOSPITAL DR
PGHC ANESTHESIA ASSOCIATES
CHEVERLY, MD
ZIP 20785

(301) 618-6100

ANN LOUISE SILVONEK CNM

Advanced Practice Midwife

3001 HOSPITAL DR
CHEVERLY, MD
ZIP 20785

(301) 618-2355

PAMELA DURNING M.D.

Anesthesiology

3001 HOSPITAL DR
CHEVERLY, MD
ZIP 20785

(301) 618-6100

THELMA CUNNINGHAM CRNA

Anesthesiology

3001 HOSPITAL DR
CHEVERLY, MD
ZIP 20785

(301) 618-6100

DR. DANIEL R. ALEXANDER M.D.

Internal Medicine

3001 HOSPITAL DR
CHEVERLY, MD
ZIP 20785

(301) 618-2000

DR. DONALD CHUKWUEMEKA EGBUONU M.D., F.A.A.P.

Pediatrics

3001 HOSPITAL DR
MT WASHINGTON PEDS HOSPITAL, 6TH FLOOR PGHC
CHEVERLY, MD
ZIP 20785

(301) 618-3864

MARGARET M RIZZUTTI CRNA

Nurse Anesthetist, Certified Registered

3001 HOSPITAL DR
CHEVERLY, MD
ZIP 20785

(443) 332-4088

ALLIED BEHAVIORAL SERVICES, INC

Psychiatry & Neurology

(Psychiatry)

3001 HOSPITAL DR
CHEVERLY, MD
ZIP 20785

(301) 618-2000

LONNIE HERRING CRNA

Nurse Anesthetist, Certified Registered

3001 HOSPITAL DR
CHEVERLY, MD
ZIP 20785

(301) 618-6100

JACQUELYN TYSON-HOPE CRNA

Nurse Anesthetist, Certified Registered

3001 HOSPITAL DR
CHEVERLY, MD
ZIP 20785

(301) 618-6100

MR. JAMIE CHEN CRNA

Nurse Anesthetist, Certified Registered

3001 HOSPITAL DR
CHEVERLY, MD
ZIP 20785

(410) 793-0791

DAVID JOHN GIBSON P.A.

Physician Assistant

3001 HOSPITAL DR
PRINCE GEORGE'S HOSPITAL CENTER
CHEVERLY, MD
ZIP 20785

(301) 618-3550

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1952806051, enumerated as an "individual" on March 29, 2018.

The provider is located at 3001 HOSPITAL DR CHEVERLY, MD 20785 and the phone number is (301) 618-2273.

Internal Medicine with taxonomy code 207R00000X.

Priyanka Vichare is affiliated with: WINCHESTER MEDICAL CENTER and SHENANDOAH MEMORIAL HOSPITAL.