LAKSHMI SANIVARAPU MD
NPI 1831521152
Internal Medicine in Johnson City, NY


Quality Rating: 89.89 out of 100 score

NPI Status: Active since August 09, 2013

Contact Information

507 MAIN ST
JOHNSON CITY, NY
ZIP 13790
Phone: (607) 763-6075
Fax: (607) 763-5234

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  • Individual
  • Female
  • Years of Experience 22
  • Internal Medicine
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About LAKSHMI SANIVARAPU

This page provides the complete NPI Profile along with additional information for Lakshmi Sanivarapu, an internist established in Johnson City, New York with a medical specialization in Internal Medicine and more than 22 years of experience. The healthcare provider is registered in the NPI registry with number 1831521152 assigned on August 2013. The practitioner's primary taxonomy code is 207R00000X with license number 285575 (NY). The provider is registered as an individual and her NPI record was last updated 7 years ago.

NPI
1831521152
Provider Name
LAKSHMI SANIVARAPU MD
Gender
Female
Entity Type
Individual
Location Address
507 MAIN ST JOHNSON CITY, NY 13790
Location Phone
(607) 763-6075
Location Fax
(607) 763-5234
Mailing Address
33 LEWIS RD 2ND FLOOR BINGHAMTON, NY 13905
Mailing Phone
(607) 729-8156
Medical School Name
OTHER
Graduation Year
2004
Is Sole Proprietor?
No
Enumeration Date
08-09-2013
Last Update Date
12-20-2018
Code Navigator

An internist like Lakshmi Sanivarapu 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.

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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.
285575
License State
NY
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

Lakshmi Sanivarapu 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.

Lakshmi Sanivarapu 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: 9335379965

    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: I20160919001808

    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.

Orthotic Devices

  • DME-Orthotic Devices (DF000N)

    Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) (HCPCS:A4314)

    2 DME suppliers used 30 Medicare Claims 30 Services Paid

  • DME-Orthotic Devices (DF000N)

    Urinary catheter anchoring device, leg strap, each (HCPCS:A4334)

    1 DME suppliers used 26 Medicare Claims 26 Services Paid

  • DME-Orthotic Devices (DF000N)

    Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each (HCPCS:A4357)

    2 DME suppliers used 51 Medicare Claims 59 Services Paid

  • DME-Orthotic Devices (DF000N)

    Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each (HCPCS:A4358)

    1 DME suppliers used 16 Medicare Claims 32 Services Paid

Durable Medical Equipment

  • DME-Wheelchairs (DD000N)

    Standard wheelchair (HCPCS:K0001)

    1 DME suppliers used 13 Medicare Claims 13 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 101 times for 93 patients

Follow-up nursing facility visit per day, typically 15 minutes

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

This service was performed 25 times for 19 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 13 times for 12 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 144 times for 66 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 62 times for 58 patients

Initial nursing facility visit per day, typically 45 minutes

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

This service was performed 39 times for 35 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $31.6 for a new patient copayment and $24.27 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 13790 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $126.4
  • Minimum New Patient Price $54.87
  • Maximum New Patient Price $166.88
  • Average New Patient Copayment $31.6
  • Minimum New Patient Copayment $13.71
  • Maximum New Patient Copayment $41.72

Established Patients Visit Costs *

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

  • Average Established Patient Price $97.08
  • Minimum Established Patient Price $17.54
  • Maximum Established Patient Price $136.14
  • Average Established Patient Copayment $24.27
  • Minimum Established Patient Copayment $4.38
  • Maximum Established Patient Copayment $34.03

* 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 89.89, 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: 89.89 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: 79.29

    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.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Closing the Referral Loop: Receipt of Specialist Report 54% 74
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
Electronic submission of Patient Centered Medical Home accreditationYesN/A
I attest that I am a Patient Centered Medical Home (PCMH) or Comparable Specialty Practice that has achieved certification from a national program, regional or state program, private payer, or other body that administers patient-centered medical home accreditation and should receive full credit for the Improvement Activities performance category.
Engagement of community for health status improvementYesN/A
Take steps to improve health status of communities, such as collaborating with key partners and stakeholders to implement evidenced-based practices to improve a specific chronic condition. Refer to the local Quality Improvement Organization (QIO) for additional steps to take for improving health status of communities as there are many steps to select from for satisfying this activity. QIOs work under the direction of CMS to assist MIPS eligible clinicians and groups with quality improvement, and review quality concerns for the protection of beneficiaries and the Medicare Trust Fund.
Falls: Screening for Future Fall Risk 77% 35
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
Implementation of fall screening and assessment programsYesN/A
Implementation of fall screening and assessment programs to identify patients at risk for falls and address modifiable risk factors (e.g., Clinical decision support/prompts in the electronic health record that help manage the use of medications, such as benzodiazepines, that increase fall risk).
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Pneumococcal Vaccination Status for Older Adults 71% 35
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Screening for Depression and Follow-Up Plan 94% 182
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
Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms.YesN/A
Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms.
Use of High-Risk Medications in the Elderly 0% "Inverse Quality Measure"
This is an inverse quality measure, a lower rate means the provider is rated better.
35
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication

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. Lakshmi Sanivarapu is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
UNITED HEALTH SERVICES HOSPITALS, INC10-42 MITCHELL AVENUE
BINGHAMTON, NY 13903
(607) 763-6000Acute Care Hospitals

Reviews for LAKSHMI SANIVARAPU 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.
1831521152
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
28611022110
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 6 + 1 + 1 + 0 + 2 + 2 + 1 + 1 + 0 + 24 = 48
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 48 = 22

The NPI number 1831521152 is valid because the calculated check digit 2 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
1831190867 ROY D GILL MD
Individual
Internal Medicine507 MAIN ST
JOHNSON CITY, NY 13790
(607) 763-8008
1881793529 BARBARA H BROZOVIC FNP
Individual
Nurse Practitioner (Family)507 MAIN ST
JOHNSON CITY, NY 13790
(607) 763-8008
1659470326 MAUREEN ELIZABETH MCPHEE FNP
Individual
Nurse Practitioner (Family)507 MAIN ST
JOHNSON CITY, NY 13790
(607) 763-8008
1700073038GENADIJ SIENKIEWICZ MD, PC
Organization
Dermatology507 MAIN ST
JOHNSON CITY, NY 13790
(607) 727-1019
1831185222 JERROLD P SCHWARTZ MD
Individual
Internal Medicine (Geriatric Medicine)507 MAIN ST
JOHNSON CITY, NY 13790
(607) 763-8008
1649361460 MICHELE P MCCABE CSW
Individual
Social Worker (Clinical)507 MAIN ST
JOHNSON CITY, NY 13790
(607) 763-8008
1710214259DR. VARUN V REDDY M.D.
Individual
Psychiatry & Neurology (Neurology)507 MAIN ST
JOHNSON CITY, NY 13790
(607) 763-8008
1043310287 MAUREEN MAY RD
Individual
Dietitian, Registered507 MAIN ST
JOHNSON CITY, NY 13790
(607) 763-8008
1417248113 SPENCER EISENBERG DO
Individual
Internal Medicine (Geriatric Medicine)507 MAIN ST
JOHNSON CITY, NY 13790
(607) 763-8008
1790778876 MARYANNE E MODRAK MD
Individual
Internal Medicine507 MAIN ST
JOHNSON CITY, NY 13790
(607) 763-8008
1740633742 VINOJA VANNIYASINGAM MD
Individual
Student in an Organized Health Care Education/Training Program507 MAIN ST
JOHNSON CITY, NY 13790
(607) 763-6075
1730172792 JEFFREY GRAY MD
Individual
Hospitalist507 MAIN ST
JOHNSON CITY, NY 13790
(607) 763-8008
1497281505 JASMIN KOHLI MD
Individual
Student in an Organized Health Care Education/Training Program507 MAIN ST
JOHNSON CITY, NY 13790
(607) 763-6075
1538684295 SABEEN KHALID DO
Individual
Student in an Organized Health Care Education/Training Program507 MAIN ST
JOHNSON CITY, NY 13790
(607) 763-6075
1982120648 VISHAL ANUGU MD
Individual
Student in an Organized Health Care Education/Training Program507 MAIN ST
JOHNSON CITY, NY 13790
(607) 763-6075
1366416521 MARIANNE SODEN D.O.
Individual
Internal Medicine507 MAIN ST
JOHNSON CITY, NY 13790
(607) 763-6075
1790271542 JOSHUA JOSEPH
Individual
Student in an Organized Health Care Education/Training Program507 MAIN ST
JOHNSON CITY, NY 13790
(607) 763-6075
1235625005 MOHAMMAD HUMZA QURESHI
Individual
Student in an Organized Health Care Education/Training Program507 MAIN ST
JOHNSON CITY, NY 13790
(607) 763-6075
1679069462 RAHAL BALASURIYA
Individual
Student in an Organized Health Care Education/Training Program507 MAIN ST
JOHNSON CITY, NY 13790
(607) 763-6075
1588041479 CORINA ARANA DO
Individual
Family Medicine507 MAIN ST
JOHNSON CITY, NY 13790
(607) 763-6075

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1831521152, enumerated in the NPI registry as an "individual" on August 09, 2013

The provider is located at 507 Main St Johnson City, Ny 13790 and the phone number is (607) 763-6075

The provider's speciality is Internal Medicine with taxonomy code 207R00000X

The provider has more than 22 years of experience.

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 $126.4 with an average copayment of $31.6 for new patient appointments. Established patients should expect a typical charge of $97.08 and an average copayment of 24.27. 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: Advance care planning, first 30 minutes, Follow-up nursing facility visit per day, typically 15 minutes, Follow-up nursing facility visit per day, typically 25 minutes, Follow-up nursing facility visit per day, typically 25 minutes, Initial nursing facility visit per day, typically 35 minutes and Initial nursing facility visit per day, typically 45 minutes.

The practitioner is affiliated to the following hospital(s): UNITED HEALTH SERVICES HOSPITALS, INC. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on August 09, 2013. 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].
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