PRAVEENA WALTER ARYA
NPI 1790166239
Obstetrics & Gynecology in Aurora, IL
Quality Rating: 81.85 out of 100 score
NPI Status: Active since June 10, 2015
Contact Information
400 N HIGHLAND AVE
AURORA, IL
ZIP 60506
Phone: (312) 927-1479
- Individual
- Female
- Years of Experience 21
- Obstetrics & Gynecology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About PRAVEENA ARYA
This page provides the complete NPI Profile along with additional information for Praveena Arya, a women's health care provider established in Aurora, Illinois with a medical specialization in Obstetrics & Gynecology and more than 21 years of experience. The healthcare provider is registered in the NPI registry with number 1790166239 assigned on June 2015. The practitioner's primary taxonomy code is 207V00000X with license number 036147980 (IL). The provider is registered as an individual and her NPI record was last updated 6 years ago.
- NPI
- 1790166239
- Provider Name
- PRAVEENA WALTER ARYA
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 400 N HIGHLAND AVE AURORA, IL 60506
- Location Phone
- (312) 927-1479
- Mailing Address
- 8335 116TH ST APT 1B RICHMOND HILL, NY 11418
- Mailing Phone
- (312) 927-1479
- Medical School Name
- OTHER
- Graduation Year
- 2005
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-10-2015
- Last Update Date
- 07-03-2019
- Code Navigator
Women's health care providers like Praveena Arya treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, 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
Obstetrics & Gynecology
- Taxonomy Code
- 207V00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 036147980
- License State
- IL
- Taxonomy Description
- An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - EPO
- Choice Bronze HSA + Vision + Adult Dental - EPO
- Clear Silver - EPO
- Clear Silver + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Standard Silver + Vision + Adult Dental - EPO
- Anthem Bronze Preferred Blue PPO 5000/10%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 5000/20%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 6500/30%/9200 Value - PPO
- Anthem Bronze Preferred Blue PPO 7000/50%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 8500/50%/9200 - PPO
- Anthem Gold Preferred Blue PPO 1000/20%/7500 - PPO
- Anthem Gold Preferred Blue PPO 2000/0%/6500 RxD - PPO
- Anthem Gold Preferred Blue PPO 2000/10%/4600 w/HSA - PPO
- Anthem Gold Preferred Blue PPO 2000/10%/7500 - PPO
- Anthem Gold Preferred Blue PPO 2000/20%/4600 w/HSA - PPO
- Anthem Gold Preferred Blue PPO 3000/0%/5500 RxD - PPO
- Anthem Gold Preferred Blue PPO 500/25%/7000 - PPO
- Anthem Platinum Preferred Blue PPO 250/10%/3500 - PPO
- Anthem Silver Preferred Blue PPO 2000/30%/9000 Value - PPO
- Anthem Silver Preferred Blue PPO 3000/20%/8500 - PPO
- Anthem Silver Preferred Blue PPO 3000/30%/9000 Value - PPO
- Anthem Silver Preferred Blue PPO 3500/20%/7250 w/HSA - PPO
- Anthem Silver Preferred Blue PPO 4000/0%/8500 - PPO
- Anthem Silver Preferred Blue PPO 4000/0%/8500 RxD - PPO
- Anthem Silver Preferred Blue PPO 4000/10%/7250 w/HSA - PPO
- Anthem Bronze Pathway X Enhanced 6000/35% HSA - HMO
- Anthem Bronze Pathway X Enhanced 6500/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway X Enhanced 7500/50% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Catastrophic Pathway X Enhanced 9200/0% - HMO
- Anthem Gold Pathway X Enhanced 1200/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Gold Pathway X Enhanced 1500/25% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Gold Pathway X Enhanced 700/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Bronze Pathway X Enhanced 6000/30% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Silver Pathway X Enhanced 4000/0% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway X Enhanced 4500/20% HSA - HMO
- Anthem Silver Pathway X Enhanced 5000/40% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Silver Pathway X Enhanced 5500/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Access Blue New England HMO 5000/10%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 5000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 6500/30%/9200 Value - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
- Anthem Bronze Pathway X HMO 5000/10%/8000 w/HSA - HMO
- Anthem Bronze Pathway X HMO 5000/20%/8000 w/HSA - HMO
- Anthem Bronze Pathway X HMO 6500/30%/9200 Value - HMO
- NH Local Choice HMO Bronze 8000 - HMO
- NH Local Choice HMO Gold - HMO
- NH Local Choice HMO Gold 1400 - HMO
- NH Local Choice HMO HSA Bronze 6000 - HMO
- NH Local Choice HMO Silver 3500 - HMO
- NH Local Choice HMO Silver 5000 - HMO
- NH Local HMO Bronze 7500 Standard - HMO
- NH Local HMO Gold 1500 Standard - HMO
- NH Local HMO Silver 5000 Standard - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Praveena Arya 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.
Praveena Arya 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: 1052656121
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: I20221011001681
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
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $34.35 for a new patient copayment and $18.59 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 60506 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $137.43
- Minimum New Patient Price $59.81
- Maximum New Patient Price $181.38
- Average New Patient Copayment $34.35
- Minimum New Patient Copayment $14.95
- Maximum New Patient Copayment $45.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $74.38
- Minimum Established Patient Price $19.15
- Maximum Established Patient Price $147.12
- Average Established Patient Copayment $18.59
- Minimum Established Patient Copayment $4.78
- Maximum Established Patient Copayment $36.78
* 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 81.85, 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.
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Final Score: 81.85 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.
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Quality Score: 68.65
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.
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Promoting Interoperability Score: 83.33
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. Praveena Arya is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| ST JOSEPH HOSPITAL | 172 KINSLEY ST NASHUA, NH 03060 | (603) 882-3000 | Acute Care Hospitals |
Reviews for PRAVEENA WALTER ARYA
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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. | |||||||||
| 1 | 7 | 9 | 0 | 1 | 6 | 6 | 2 | 3 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 18 | 0 | 2 | 6 | 12 | 2 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 8 + 0 + 2 + 6 + 1 + 2 + 2 + 6 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1790166239 is valid because the calculated check digit 9 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 |
|---|---|---|---|
| 1508870643 | BARBARA A WELCH RN, APN-C Individual | Nurse Practitioner | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 978-2532 |
| 1871509893 | SONJA M ROSS APN Individual | Nurse Practitioner | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 978-2532 |
| 1518975994 | AFIFA G. MINA M.D. Individual | Pediatrics | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 978-2532 |
| 1952311771 | PAMELA H TAYLOR APN/FNP Individual | Nurse Practitioner (Family) | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 978-2532 |
| 1417967134 | JENNIFER RUTH STEFFEN Individual | Social Worker (Clinical) | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 978-2532 |
| 1558479113 | YUHANG SHEK M.D. Individual | Obstetrics & Gynecology | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 978-2532 |
| 1831299338 | DONNA ANN KOURI P.T. Individual | Physical Therapist | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 978-2532 |
| 1548352271 | LYNN MARIE METKE OTR/L Individual | Occupational Therapist | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 978-2532 |
| 1114012184 | PATRICIA M ANTONELLI RD, LDN, CDE Individual | Dietitian, Registered | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 978-2532 |
| 1255429130 | ALDONA R STARKUS D.D.S. Individual | Dentist | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 978-2532 |
| 1851470652 | NIRMALA C GOVINDA M.D. Individual | Family Medicine | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 978-2532 |
| 1548393846 | NEERU BHATIA PT Individual | Physical Therapist | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 978-2532 |
| 1699808972 | MANDA M MARSHALL PTA Individual | Physical Therapy Assistant | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 978-2532 |
| 1669596755 | VNA HEALTH CARE Organization | Clinic/Center (Federally Qualified Health Center (FQHC)) | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 978-2532 |
| 1922122019 | VNA HEALTH CARE Organization | Clinic/Center (Federally Qualified Health Center (FQHC)) | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 978-2532 |
| 1942324033 | VNA HEALTH CARE Organization | Clinic/Center (Federally Qualified Health Center (FQHC)) | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 978-2532 |
| 1376763912 | DR. ALITHEA CELINA MILAGROS DACANAY M.D. Individual | Family Medicine | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 892-4720 |
| 1356505994 | VNA HEALTH CARE Organization | Radiologic Technologist (Mammography) | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 978-2532 |
| 1164686705 | VNA HEALTH CARE Organization | Audiologist | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 978-2532 |
| 1932363173 | DR. SARA ASHLEY VELARDE M.D. Individual | Pediatrics | 400 N HIGHLAND AVE AURORA, IL 60506 (630) 978-2532 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1790166239, enumerated in the NPI registry as an "individual" on June 10, 2015
The provider is located at 400 N Highland Ave Aurora, Il 60506 and the phone number is (312) 927-1479
The provider's speciality is Obstetrics & Gynecology with taxonomy code 207V00000X
The provider has more than 21 years of experience.
The provider might be accepting Accepts: Ambetter from NH Healthy Families, Anthem Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
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.
The provider has an overall high rating in the following quality measures: uses technology to exchange and make use of healthcare information.
Medicare beneficiaries should expect a typical cost of $137.43 with an average copayment of $34.35 for new patient appointments. Established patients should expect a typical charge of $74.38 and an average copayment of 18.59. Please review your insurance plan or contact the provider directly to determine your specific costs.
The practitioner is affiliated to the following hospital(s): ST JOSEPH 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 June 10, 2015. 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.