DR. RAJ PRATAP MATHUR MD
NPI 1992864177
Internal Medicine - Geriatric Medicine in Washington, DC

Q: What is Raj Mathur's NPI number?

The NPI number for Raj Mathur is 1992864177. It was assigned to this individual provider in the NPPES registry on December 6, 2006.

Q: What is Raj Mathur's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

Q: When was this NPI record last updated?

The NPPES record for Raj Mathur was last updated on March 7, 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.

Active since December 06, 2006PECOS EnrolledAccepts Medicare Assignment

46/100

CMS Quality Rating

106 IRVING ST NW STE 211, WASHINGTON, DC 20010(202) 722-0149 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 7, 2023, Aug 11, 2021 (2 updates tracked since 2021).

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About Dr. Raj Pratap Mathur Md NPPES

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

DR. RAJ PRATAP MATHUR MD (NPI 1992864177) is an individual geriatric medicine provider in Washington, District Of Columbia, licensed in District Of Columbia (MD19927) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1978).

NPPES Registry Identity

NPI1992864177

Entity TypeIndividualMale

Primary Taxonomy207RG0300X

Provider Legal NameDR. RAJ PRATAP MATHURCredential: MD

Location Address106 IRVING ST NW STE 211Washington, DC 20010-2993

Mailing Address10218 Yearling DrRockville, MD 20850-3548 · (240) 252-4008

Phone(202) 722-0149

Sole ProprietorYes

Medical School CMSOtherGraduated 1978

Enumeration DateDecember 6, 2006

Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration

NPPES CertifiedAugust 11, 2021

✔ NPI 1992864177 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RG0300X

Licenses✔ Licensed in DC · MD19927✔ Licensed in VA · 0101054105✔ Licensed in MD · D0042403

Definition

An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.

106 IRVING ST NW STE 211, Washington, DC 20010

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Other Identifiers 10

Other0402333United Healthcare

Other54357601MD · Bcbs

Other522004721Alliance Ppo

Other68766Amerigroup

Other7133432Aetna Ppo

Other40840001DC · Bcbs

Medicaid090902501MD

Medicaid010371400DC

Other865068Mdipa

Other2241948DC · Aetna Dc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health Maintenance Organization of Florida.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. Raj Pratap Mathur 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 ID7517852437

PECOS Enrollment IDI20040219000345

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 16

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.

464 services236 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

151 services151 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

130 services130 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

67 services64 patients

Physician or allowed practitioner re-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 a G0179

This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.

41 services31 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

37 services31 patients

Ultrasound study of arm and leg arteries 93922

An ultrasound study of arm and leg arteries is a non-invasive procedure that uses sound waves to create images of your arteries. It helps in checking blood flow, identifying blockages, or detecting other abnormalities in your arteries.

36 services34 patients

Ultrasound of leg arteries or artery grafts 93925

An ultrasound of leg arteries or artery grafts is a non-invasive imaging test. It uses high-frequency sound waves to capture live images from inside your body, specifically your leg arteries or grafts. This helps in detecting any blockages or abnormalities.

30 services30 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

25 services25 patients

Influenza vaccine, quadrivalent derived from cell cultures 90756

The quadrivalent influenza vaccine, derived from cell cultures, is a flu shot that protects against four different flu viruses. It's made in labs using cell cultures instead of eggs, making it a good option for those with egg allergies. It's a crucial tool in preventing the flu.

20 services19 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

18 services17 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

14 services12 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

14 services13 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

14 services12 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 G0180

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.

13 services13 patients

Complete ultrasound study of arm and leg arteries 93923

This procedure involves using sound waves to produce images of your arm and leg arteries. It helps identify blockages or abnormalities that could lead to conditions like stroke or peripheral artery disease. It's non-invasive and painless.

12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20010 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

$194.86 typical visit price

range $65.18 – $194.86

Typical copayment $48.71 (range $16.29 – $48.71)

Most-billed visit code 99205

Established Patient

$113.72 typical visit price

range $21.40 – $158.88

Typical copayment $28.43 (range $5.35 – $39.72)

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.

46/100

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

Individually scored

Quality

Improvement Activities

Cost

100

Reported Quality Measures

Clinical Information Reconciliation

For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation.

97%270 patients4/55-star benchmark: 100%

Diabetes: Medical Attention for Nephropathy

The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period

95%207 patients4/55-star benchmark: 99%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

95%2,151 patients4/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

95%6,929 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…

99%992 patients4/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

69%445 patients4/55-star benchmark: 90%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

20%985 patients1/55-star benchmark: 97%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen

98%908 patients5/55-star benchmark: 96%

Provide Patient Access

For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…

52%992 patients3/55-star benchmark: 100%

Send a Summary of Care

For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider-(1) creates a summary of care record using certified EHR technology; and (2)…

0%354 patients1/55-star benchmark: 100%

View, Download and Transmit (VDT)

During the performance period, at least one unique patient (or patient-authorized representatives) seen by the MIPS eligible clinician actively engages with the EHR made accessible by the MIPS eligible clinician.

2%992 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.

Referred Medical Equipment & Supplies CMS DME claims 5

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

9 suppliers19 claims49 services$4.54 avg. paid by Medicare

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

DME-Hospital Beds · category DB000N

3 suppliers23 claims23 services$42.42 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

1 supplier12 claims12 services$14.59 avg. paid by Medicare

Lightweight wheelchair K0003

DME-Wheelchairs · category DD000N

2 suppliers13 claims20 services$20.55 avg. paid by Medicare

Ultralightweight wheelchair K0005

DME-Wheelchairs · category DD000N

1 supplier12 claims12 services$127.46 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 5

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

CAPITAL INTERNAL MEDICINE & GERIATRICS LLC

Internal Medicine (Geriatric Medicine)