Niraj Bhalani, DO
NPI 1255838363 · Gastroenterology Physician · Templeton, CA
Enrolled with Medicare as Practitioner - Internal Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Niraj Bhalani, DO is a Gastroenterology Physician provider in Templeton, CA (NPI 1255838363).
Provider details
- NPI number
- 1255838363
- Entity type
- Individual
- Primary specialty
- Gastroenterology PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- License
- 17979 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
8 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
4 documented practice locations
- Medicare service volume (vs. specialty peers)25% of score
95 Medicare services, 2024 (ranked within specialty)
- Open Payments transparency10% of score
Has Open Payments disclosures (2024)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our .
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| New Patient Office Or Other Outpatient Visit With Low Level of Medical Decision Making, If Using Time, 30 Minutes Or More99203 | 31 | $113 |
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 26 | $93 |
| New Patient Office Or Other Outpatient Visit With Moderate Level of Medical Decision Making, If Using Time, 45 Minutes Or More99204 | 16 | $169 |
| Biopsy of Esophagus, Stomach, And/Or Upper Small Bowel Using a Flexible Endoscope43239 | 11 | $98 |
| Telephone Medical Discussion With Physician, 11-20 Minutes99442 | 11 | $92 |
Typical Medicare-allowed amounts for these services range $92–$169 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 3 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Peg3350/Sod Sulf,bicarb,cl/Kclbrand: Gavilyte-G | 28 | 28 |
| Sodium, Potassium,mag Sulfatesbrand: Sod Sulf-Potass Sulf-Mag Sulf | 14 | 12 |
| Pantoprazole Sodium | 13 | — |
Medicare Part D only. These counts cover prescriptions paid through Medicare Part D in 2024 — they do notinclude cash-pay, commercial-insurance, Medicaid, or Part B–administered drugs, and badly undercount high cash-pay categories (e.g. GLP-1 weight-loss, testosterone, and ED medications). Any drug with 10 or fewer claims is omitted by CMS, and beneficiary counts under 11 are suppressed — so a missing drug means no Part D record, never zero. This is a factual claims summary, not an endorsement, not medical advice, and not a consumer report. Source: CMS Medicare Part D Prescribers — by Provider and Drug.
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$261 across 8 records (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Additional practice locations (3)
- 850 Fair Oaks Ave Ste 220Arroyo Grande, CA 93420-3929Phone: (805) 434-5530Fax: (805) 434-0023
- 155 N Fresno StFresno, CA 93701-2302Phone: (559) 499-6500
- 1551 Bishop St Ste 230San Luis Obispo, CA 93401-4661Phone: (805) 434-5530Fax: (805) 434-0023
Registry dates
- Enumerated
- 2018-04-06
- Last updated
- 2026-03-17
- Certified
- 2026-03-17
Frequently asked questions
- What is Niraj Bhalani's NPI number?
- Niraj Bhalani's National Provider Identifier (NPI) is 1255838363, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Niraj Bhalani's specialty?
- Niraj Bhalani is listed in the NPPES registry with a primary specialty of Gastroenterology Physician (Allopathic & Osteopathic Physicians).
- Where is Niraj Bhalani located?
- Niraj Bhalani's practice location on file with NPPES is 350 Posada Ln Ste 202, Templeton, CA 93465-4060.
- What is Niraj Bhalani's phone number?
- The practice phone number listed in the NPPES registry for Niraj Bhalani is (805) 434-5530.
- Does Niraj Bhalani accept Medicare?
- Niraj Bhalani is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Niraj Bhalani's NPI active?
- Yes — Niraj Bhalani's NPI (1255838363) is active in the NPPES registry as of the last update on 2026-03-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.