SANJAY BASU NADESAN MD
NPI 1720512361
Emergency Medicine in Newark, DE


Quality Rating: 75 out of 100 score

NPI Status: Active since April 19, 2017

Contact Information

4755 OGLETOWN STANTON RD
NEWARK, DE
ZIP 19718
Phone: (302) 733-1042

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  • Individual
  • Male
  • Years of Experience 9
  • Emergency Medicine
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About SANJAY NADESAN

This page provides the complete NPI Profile along with additional information for Sanjay Nadesan, a provider established in Newark, Delaware with a medical specialization in Emergency Medicine and more than 9 years of experience. He graduated from University Of Texas Southwestern Medical School At Dallas in 2017. The healthcare provider is registered in the NPI registry with number 1720512361 assigned on April 2017. The practitioner's primary taxonomy code is 207P00000X with license number 314926 (NY). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI
1720512361
Provider Name
SANJAY BASU NADESAN MD
Gender
Male
Entity Type
Individual
Location Address
4755 OGLETOWN STANTON RD NEWARK, DE 19718
Location Phone
(302) 733-1042
Mailing Address
4755 OGLETOWN STANTON RD NEWARK, DE 19718
Mailing Phone
(302) 733-1042
Medical School Name
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Graduation Year
2017
Is Sole Proprietor?
Yes
Enumeration Date
04-19-2017
Last Update Date
06-19-2024
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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

Emergency Medicine

Taxonomy Code
207P00000X
Type
Allopathic & Osteopathic Physicians
License No.
314926
License State
NY
Taxonomy Description
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.

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)
1207P00000XAllopathic & Osteopathic Physicians

Emergency Medicine

MD25906 (ME)

Medicare Participation & PECOS Enrollment Status

Sanjay Nadesan 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.

Sanjay Nadesan 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: 3173892262

    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: I20230125000886

    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

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.

Emergency department visit for life threatening or functioning severity

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.

This service was performed 35 times for 35 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 25 times for 14 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $22.09 for a new patient copayment and $25.17 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 19718 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $88.37
  • Minimum New Patient Price $57.12
  • Maximum New Patient Price $173.08
  • Average New Patient Copayment $22.09
  • Minimum New Patient Copayment $14.28
  • Maximum New Patient Copayment $43.27

Established Patients Visit Costs *

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

  • Average Established Patient Price $100.68
  • Minimum Established Patient Price $18.36
  • Maximum Established Patient Price $141.05
  • Average Established Patient Copayment $25.17
  • Minimum Established Patient Copayment $4.59
  • Maximum Established Patient Copayment $35.26

* 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 75, 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: 75 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: N/A

    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: N/A

    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: N/A

    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. Sanjay Nadesan is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
NORTHERN LIGHT A R GOULD HOSPITALPO BOX 151
PRESQUE ISLE, ME 04769
(207) 768-4000Acute Care Hospitals
NORTHERN LIGHT INLAND HOSPITAL200 KENNEDY MEMORIAL DRIVE
WATERVILLE, ME 04901
(207) 861-3000Acute Care Hospitals
NORTHERN LIGHT MAYO HOSPITAL897 WEST MAIN STREET
DOVER FOXCROFT, ME 04426
(207) 564-4251Critical Access Hospitals
NORTHERN LIGHT SEBASTICOOK VALLEY HOSPITAL447 NORTH MAIN STREET
PITTSFIELD, ME 04967
(207) 487-5141Critical Access Hospitals

Reviews for SANJAY BASU NADESAN MD

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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.
1720512361
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
27401014312
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 4 + 0 + 1 + 0 + 1 + 4 + 3 + 1 + 2 + 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 1720512361 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.

NPI Name / Type Taxonomy Address
1336145861DR. CYNTHIA ELLEN FLYNN MD
Individual
Pathology (Anatomic Pathology & Clinical Pathology)4755 OGLETOWN STANTON RD
NEWARK, DE 19718
(302) 454-9830
1689670119DR. MARY VIRGINIA IACOCCA MD
Individual
Pathology (Anatomic Pathology & Clinical Pathology)4755 OGLETOWN STANTON RD
NEWARK, DE 19718
(302) 454-9830
1194721639DR. MICHAEL DOUGLAS KANZER MD
Individual
Pathology (Anatomic Pathology & Clinical Pathology)4755 OGLETOWN STANTON RD
NEWARK, DE 19718
(302) 454-9830
1396741849DR. GARY BRUCE WITKIN MD
Individual
Pathology (Anatomic Pathology & Clinical Pathology)4755 OGLETOWN STANTON RD
NEWARK, DE 19718
(302) 454-9830
1487650594DR. MARK L MITCHELL MD
Individual
Pathology (Anatomic Pathology & Clinical Pathology)4755 OGLETOWN STANTON RD
NEWARK, DE 19718
(302) 454-9830
1265438360DR. WILLIAM MACLEOD KIRBY MD
Individual
Pathology (Anatomic Pathology & Clinical Pathology)4755 OGLETOWN STANTON RD
NEWARK, DE 19718
(302) 454-9830
1477538791 MATTHEW K HOFFMAN MD
Individual
Obstetrics & Gynecology4755 OGLETOWN STANTON RD DEPT. OF OB/GYN
NEWARK, DE 19718
(302) 733-6518
1538144266 DIANE C BOHNER MD
Individual
Internal Medicine4755 OGLETOWN STANTON RD NEWARK
NEWARK, DE 19718
(302) 733-1000
1487632303 PAUL R SIERZENSKI MD
Individual
Emergency Medicine4755 OGLETOWN STANTON RD
NEWARK, DE 19718
(302) 733-1000
1306824107 STEVEN KUSHNER MD
Individual
Emergency Medicine4755 OGLETOWN STANTON RD
NEWARK, DE 19718
(302) 733-1000
1477531275 JASON E NACE MD
Individual
Emergency Medicine4755 OGLETOWN STANTON RD
NEWARK, DE 19718
(302) 733-1000
1295713006 JAMES M CARROLL MD
Individual
Emergency Medicine4755 OGLETOWN STANTON RD
NEWARK, DE 19718
(302) 733-1000
1194703900 ANITA H HODSON MD
Individual
Emergency Medicine4755 OGLETOWN STANTON RD
NEWARK, DE 19718
(302) 733-1000
1285612093 CORY T CARPENTER MD
Individual
Emergency Medicine4755 OGLETOWN STANTON RD
NEWARK, DE 19718
(302) 733-1000
1154309078 LAURA A LAWLER MD
Individual
Pediatrics4755 OGLETOWN STANTON RD CHRISTIANA HOSPITAL, DEPT OF PEDIATRICS
NEWARK, DE 19718
(302) 733-6500
1598743312DR. CEM SOYKAN MD
Individual
Pediatrics (Neonatal-Perinatal Medicine)4755 OGLETOWN STANTON RD DEPT. OF PEDIATRICS
NEWARK, DE 19718
(302) 733-4200
1114905924 THOMAS A SWEENEY MD
Individual
Emergency Medicine4755 OGLETOWN STANTON RD
NEWARK, DE 19718
(302) 733-1000
1578541389 BRIAN J LEVINE MD
Individual
Emergency Medicine4755 OGLETOWN STANTON RD
NEWARK, DE 19718
(302) 733-1000
1467430173 SUNANDA NABHA MD
Individual
Emergency Medicine4755 OGLETOWN STANTON RD
NEWARK, DE 19718
(302) 733-1000
1598743304 JEREMIAH L DRISCOLL PAC
Individual
Physician Assistant4755 OGLETOWN STANTON RD
NEWARK, DE 19718
(302) 733-1000

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1720512361, enumerated in the NPI registry as an "individual" on April 19, 2017

The provider is located at 4755 Ogletown Stanton Rd Newark, De 19718 and the phone number is (302) 733-1042

The provider's speciality is Emergency Medicine with taxonomy code 207P00000X

The provider has more than 9 years of experience. He graduated from University Of Texas Southwestern Medical School At Dallas in 2017.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.

Medicare beneficiaries should expect a typical cost of $88.37 with an average copayment of $22.09 for new patient appointments. Established patients should expect a typical charge of $100.68 and an average copayment of 25.17. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Emergency department visit for life threatening or functioning severity and Follow-up hospital inpatient care per day, typically 35 minutes.

The practitioner is affiliated to the following hospital(s): NORTHERN LIGHT A R GOULD HOSPITAL, NORTHERN LIGHT INLAND HOSPITAL, NORTHERN LIGHT MAYO HOSPITAL and NORTHERN LIGHT SEBASTICOOK VALLEY HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on April 19, 2017. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.