DR. SANJAY P DALAL MD
NPI 1992769699
Internal Medicine - Nephrology in Kalamazoo, MI
NPI Status: Active since April 12, 2006
Contact Information
521 E MICHIGAN AVE
SUITE 201
KALAMAZOO, MI
ZIP 49007
Phone: (269) 349-6759
Fax: (269) 349-7450
- Individual
- Male
- Internal Medicine
- Nephrology
- Accepts Insurance
- PECOS Enrolled
- Medicare Quality Reporting
About SANJAY DALAL
This page provides the complete NPI Profile along with additional information for Sanjay Dalal, an internist established in Kalamazoo, Michigan with a medical specialization in Internal Medicine, focusing in nephrology . The healthcare provider is registered in the NPI registry with number 1992769699 assigned on April 2006. The practitioner's primary taxonomy code is 207RN0300X with license number 4301055590 (MI). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1992769699
- Provider Name
- DR. SANJAY P DALAL MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 521 E MICHIGAN AVE SUITE 201 KALAMAZOO, MI 49007
- Location Phone
- (269) 349-6759
- Location Fax
- (269) 349-7450
- Mailing Address
- 521 E MICHIGAN AVE SUITE 201 KALAMAZOO, MI 49007
- Mailing Phone
- (269) 349-6759
- Mailing Fax
- (269) 349-7450
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-12-2006
- Last Update Date
- 04-28-2021
- Code Navigator
An internist like Sanjay Dalal 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.
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
Internal Medicine Nephrology
- Taxonomy Code
- 207RN0300X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 4301055590
- License State
- MI
- Taxonomy Description
- An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
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) |
|---|---|---|---|---|
| 1 | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | 4301055590 (MI) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- MyPriority Balanced Silver - HMO
- MyPriority Balanced Silver Bronson Healthcare Partners - HMO
- MyPriority Enhanced Gold Bronson Healthcare Partners - HMO
- MyPriority Premier Silver - HMO
- MyPriority Premier Silver Bronson Healthcare Partners - HMO
- MyPriority Standard Bronze - HMO
- MyPriority Standard Bronze - Bronson Healthcare Partners - HMO
- MyPriority Standard Bronze - Travel - HMO
- MyPriority Standard Gold - HMO
- MyPriority Standard Gold Bronson Healthcare Partners - HMO
- MyPriority Standard Silver - HMO
- MyPriority Standard Silver - Bronson Healthcare Partners - HMO
- MyPriority Standard Silver - Travel - HMO
- MyPriority Value Bronze - HMO
- MyPriority Value Bronze Bronson Healthcare Partners - HMO
- MyPriority Value Bronze HSA - HMO
- MyPriority Value Bronze HSA Bronson Healthcare Partners - HMO
- UHC Bronze Copay Focus (No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Value (No Referrals) - HMO
- UHC Bronze Value+ (Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage (No Referrals) - HMO
- UHC Gold Advantage+ (Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus (No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Silver Advantage (No Referrals) - HMO
- UHC Silver Advantage+ (Dental + Vision, No Referrals) - HMO
- UHC Silver Standard (No Referrals) - HMO
- UHC Silver Value (No Referrals) - HMO
- UHC Silver Value+ (Dental + Vision, No Referrals) - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1103902830 | OTHER (01) | MI | BCBS INDIVIDUAL ID |
| 3516520 | MEDICAID (05) | MI | |
| 4148071 | MEDICAID (05) | MI |
Medicare Participation & PECOS Enrollment Status
Sanjay Dalal 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
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.
Unknown
Treatment-Treatment - Miscellaneous (RX029N)
Azathioprine, oral, 50 mg (HCPCS:J7500)
1 DME suppliers used 12 Medicare Claims 360 Services Paid
Treatment-Treatment - Miscellaneous (RX029N)
Cyclosporine, oral, 100 mg (HCPCS:J7502)
2 DME suppliers used 13 Medicare Claims 1140 Services Paid
Treatment-Treatment - Miscellaneous (RX029N)
Prednisone, immediate release or delayed release, oral, 1 mg (HCPCS:J7512)
1 DME suppliers used 12 Medicare Claims 1800 Services Paid
Treatment-Chemotherapy (RH012N)
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period (HCPCS:Q0511)
3 DME suppliers used 13 Medicare Claims 13 Services Paid
Treatment-Chemotherapy (RH012N)
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period (HCPCS:Q0512)
2 DME suppliers used 27 Medicare Claims 27 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.
Established patient office or other outpatient visit, 30-39 minutes
Home dialysis services per month (20 years or older)
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.
This service was performed 64 times for 39 patientsHome dialysis services provide kidney treatment for patients aged 20 or older right in their own homes. This service includes necessary equipment, supplies, and support for performing dialysis. It's a convenient option that allows patients to maintain their daily routines while receiving essential care.
This service was performed 26 times for 12 patientsPhysician Visit Costs
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 49007 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $126.15
- Minimum New Patient Price $54.34
- Maximum New Patient Price $166.68
- Average New Patient Copayment $31.53
- Minimum New Patient Copayment $13.58
- Maximum New Patient Copayment $41.67
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $96.44
- Minimum Established Patient Price $17.09
- Maximum Established Patient Price $135.4
- Average Established Patient Copayment $24.11
- Minimum Established Patient Copayment $4.27
- Maximum Established Patient Copayment $33.85
* 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.
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 |
|---|---|---|
| Clinical Information Reconciliation | 34% | 129 |
| 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. The MIPS eligible clinician must implement clinical information reconciliation for the following three clinical information sets: (1) Medication. Review of the patient's medication, including the name, dosage, frequency, and route of each medication. (2) Medication allergy. Review of the patient's known medication allergies. (3) Current Problem list. Review of the patient's current and active diagnoses. | ||
| Documentation of Current Medications in the Medical Record | 79% | 4206 |
| 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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Engagement of patients through implementation of improvements in patient portal | Yes | N/A |
| Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence. | ||
| e-Prescribing | 88% | 812 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Immunization Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data and receive immunization forecasts and histories from the public health immunization registry/immunization information system (IIS). | ||
| Patient-Specific Education | 81% | 547 |
| 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 clinician. | ||
| Pneumococcal Vaccination Status for Older Adults | 51% | 207 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Practice Improvements for Bilateral Exchange of Patient Information | Yes | N/A |
| Ensure that there is bilateral exchange of necessary patient information to guide patient care, such as Open Notes, that could include one or more of the following: • Participate in a Health Information Exchange if available; and/or • Use structured referral notes. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 64% | 328 |
| 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 twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
| Provide Patient Access | 78% | 547 |
| 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 ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified EHR technology. | ||
| Request/Accept Summary of Care | 4% | 106 |
| 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 receives or retrieves and incorporates into the patient's record an electronic summary of care document. | ||
| Secure Messaging | 2% | 547 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative). | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Use of High-Risk Medications in the Elderly | 1% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 207 |
| 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 | ||
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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 | 9 | 9 | 2 | 7 | 6 | 9 | 6 | 9 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 18 | 2 | 14 | 6 | 18 | 6 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 1 + 8 + 2 + 1 + 4 + 6 + 1 + 8 + 6 + 1 + 8 + 24 = 81 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 90 - 81 = 9 | 9 | ||||||||
The NPI number 1992769699 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 11 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1619927563 | KAREN F ROBINSON APRN-BC Individual | Nurse Practitioner (Family) | 521 E MICHIGAN AVE SUITE 201 KALAMAZOO, MI 49007 (269) 349-6759 |
| 1659886810 | LAURA MEGHANN ROBERTSON NP-C Individual | Nurse Practitioner | 521 E MICHIGAN AVE KALAMAZOO, MI 49007 (269) 349-6759 |
| 1922057546 | AHMED AQEEL MD Individual | Internal Medicine (Nephrology) | 521 E MICHIGAN AVE SUITE 201 KALAMAZOO, MI 49007 (269) 349-6759 |
| 1083678767 | PARAGON HEALTH, PC Organization | Internal Medicine (Nephrology) | 521 E MICHIGAN AVE SUITE 201 KALAMAZOO, MI 49007 (269) 349-6759 |
| 1043260821 | AHSAN A QURESHI MD Individual | Internal Medicine (Nephrology) | 521 E MICHIGAN AVE SUITE 201 KALAMAZOO, MI 49007 (269) 349-6759 |
| 1154524338 | AASH P BHATT M.D. Individual | Internal Medicine (Nephrology) | 521 E MICHIGAN AVE SUITE 201 KALAMAZOO, MI 49007 (269) 349-6759 |
| 1184673709 | THAN N OO MD Individual | Internal Medicine (Nephrology) | 521 E MICHIGAN AVE SUITE 201 KALAMAZOO, MI 49007 (269) 349-6759 |
| 1396864401 | DR. PETER GABLE MANRING MD Individual | Internal Medicine (Nephrology) | 521 E MICHIGAN AVE SUITE 201 KALAMAZOO, MI 49007 (269) 226-2656 |
| 1407897465 | RENAL CARE GROUP SOUTHWEST MICHIGAN, LLC Organization | Clinic/Center (End-Stage Renal Disease (ESRD) Treatment) | 521 E MICHIGAN AVE KALAMAZOO, MI 49007 (269) 384-6180 |
| 1508816380 | PRINCE JIT SIDHU MD Individual | Internal Medicine (Nephrology) | 521 E MICHIGAN AVE SUITE 201 KALAMAZOO, MI 49007 (269) 349-6759 |
| 1699894709 | DR. JOON SUNG PARK MD Individual | Internal Medicine (Nephrology) | 521 E MICHIGAN AVE SUITE 201 KALAMAZOO, MI 49007 (269) 226-2656 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1992769699, enumerated in the NPI registry as an "individual" on April 12, 2006
The provider is located at 521 E Michigan Ave Suite 201 Kalamazoo, Mi 49007 and the phone number is (269) 349-6759
The provider's speciality is Internal Medicine with taxonomy code 207RN0300X with a focus in Nephrology
The provider might be accepting Accepts: Priority Health, UnitedHealthcare, Blue Cross 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.
Medicare beneficiaries should expect a typical cost of $126.15 with an average copayment of $31.53 for new patient appointments. Established patients should expect a typical charge of $96.44 and an average copayment of 24.11. 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: Established patient office or other outpatient visit, 30-39 minutes and Home dialysis services per month (20 years or older).
This NPI record was last updated on April 12, 2006. 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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