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HARSHAL ATHALYE MD
NPI 1952938433
Emergency Medicine in Miami, FL

Active since March 25, 2020PECOS EnrolledAccepts Medicare Assignment
1611 NW 12TH AVE, MIAMI, FL 33136(305) 585-6373 Get Directions Write a Review

NPPES record last updated: June 12, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 12, 2023, Mar 25, 2020 (2 updates tracked since 2020).

About Harshal Athalye Md NPPES

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

HARSHAL ATHALYE MD (NPI 1952938433) is an individual emergency medicine provider in Miami, Florida, licensed in Washington (MD61377700) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS, is affiliated with Providence Regional Medical Center Everett, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1952938433
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameHARSHAL ATHALYECredential: MD
Location Address1611 NW 12TH AVEMiami, FL 33136-1005
Mailing Address5672 Infinity Ln Unit 414Virginia Beach, VA 23464-8286
Phone(305) 585-6373
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateMarch 25, 2020
Last NPPES UpdateJune 12, 20232 updates tracked since enumeration
NPPES CertifiedJune 12, 2023
✔ NPI 1952938433 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in WA · MD61377700
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1611 NW 12TH AVE, Miami, FL 33136
Open in Google Maps ↗

Other Identifiers 2

Medicaid90000VT1000001VT
Other72570901VT · Drivers License Dmv

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.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

Harshal Athalye 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 ID8426419110
PECOS Enrollment IDI20230727001891
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 4

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
126 services124 patients
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.
122 services119 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.
44 services42 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
31 services31 patients

Hospital Affiliations CMS Care Compare

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

Providence Regional Medical Center Everett

Acute Care Hospitals · Everett, WA
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number500014
Location1321 Colby AvenueEverett, WA 98201 · Snohomish County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33136 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
$96.13 typical visit price
range $60.92 – $187.05
Typical copayment $24.03 (range $15.23 – $46.76)
Most-billed visit code 99203
Established Patient
$107.17 typical visit price
range $18.99 – $150.24
Typical copayment $26.79 (range $4.74 – $37.56)
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.

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.

DR. AKUA GYANEWAH ASARE MD
Student in an Organized Health Care Education/Training Program
1611 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 355-8264
MARILUZ SANCHEZ PHARM.D.
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1611 NW 12TH AVE, PHARMACY ADM. OFFICES/EAST TOWER BASEMENT 069
MIAMI, FL 33136
Miami-Dade County (305) 585-7309
DR. TASHA JOYTI N. D. COOKE TASHA COOKE
Student in an Organized Health Care Education/Training Program
1611 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-3670
DR. JUANITA ANN MARIE HUNTER M.D.
Pediatrics (Pediatric Cardiology)
1611 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 585-6042
WANDA LAVERNE MCGOWAN-BRAYNEN ARNP
Nurse Practitioner (Adult Health)
1611 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 585-1111
DR. PERTTI KALEVI HAKALA M.D.
Anesthesiology
1611 NW 12TH AVE, CENTRAL 300
MIAMI, FL 33136
Miami-Dade County (305) 585-6970
JAYLOU M VELEZ TORRES M.D.
Pathology (Anatomic Pathology)
1611 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 585-8381
ANNE-ISABELLE SOPHIA REME MD
Surgery
1611 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 585-1280

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 Harshal Athalye's NPI number?

The NPI number for Harshal Athalye is 1952938433. It was assigned to this individual provider in the NPPES registry on March 25, 2020.

Where is Harshal Athalye located?

Harshal Athalye practices at 1611 NW 12th Ave, Miami, FL 33136. The listed phone number is (305) 585-6373.

What is Harshal Athalye's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Harshal Athalye enrolled in Medicare?

Yes. Harshal Athalye 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 Harshal Athalye accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Harshal Athalye 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 Harshal Athalye affiliated with any hospitals?

According to CMS data, Harshal Athalye is affiliated with Providence Regional Medical Center Everett.

When was this NPI record last updated?

The NPPES record for Harshal Athalye was last updated on June 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.