DR. PRATIBHA P RAO (MD) – General Practice Physician, NPI 1346231263
General Practice Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
872 HOSPITALIST in NJ
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Provider Addresses for DR. PRATIBHA P RAO (MD)
Mountainside Hospital, 1, Bay Avenue, Glen Ridge, Essex County, New Jersey, 07042, United States
MONTCLAIR, NJ 070424837
Phone: (973) 429-6000
Type: Location
66 WEST GILBERT STREET
RED BANK, NJ 077014918
Phone: (732) 212-0060
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-08-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050824000839 | I | Hospitalist | NJ | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 237 | 125 | $0 |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 218 | 216 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 215 | 208 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 74 | 63 | $0 |
| 99239 | Hospital discharge day management, more than 30 minutes | 72 | 69 | $0 |
Insurance plans in this area (ZIP 07042)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Cardiovascular Disease (Cardiology), Advanced Heart Failure And Transplant Cardiology | NY | |
| Family Practice | NJ | |
| C H I R O P R A C T I C | NJ | |
| Internal Medicine | NJ | |
| - | PA | |
| - | NJ | |
| - | NC | |
| General Surgery | NY | |
| Certified Nurse Midwife (Cnm) | NY | |
| Nurse Practitioner | NJ |
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