Niraj Madhani, MD
NPI 1891254868 · Internal Medicine Physician · San Diego, CA
Enrolled with Medicare as Practitioner - Internal Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Niraj Madhani, MD is a Internal Medicine Physician provider in San Diego, CA (NPI 1891254868).
Provider details
- NPI number
- 1891254868
- Entity type
- Individual
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- A177048 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
7 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
2 documented practice locations
- Medicare service volume (vs. specialty peers)28% of score
52 Medicare services, 2024 (ranked within specialty)
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 methodology.
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) |
|---|---|---|
| Initial Hospital Care With Straightforward Or Low-Level Medical Decision Making, If Using Time, at Least 55 Minutes99222 | 35 | $130 |
| Initial Hospital Care With Moderate Level of Medical Decision Making, If Using Time, at Least 75 Minutes99223 | 17 | $176 |
Typical Medicare-allowed amounts for these services range $130–$176 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote 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.
Practice location
Mailing address
Additional practice locations (1)
- 5323 Harry Hines BlvdDallas, TX 75390-7201Phone: (214) 590-8000
Registry dates
- Enumerated
- 2019-03-18
- Last updated
- 2022-06-10
- Certified
- 2022-06-10
Frequently asked questions
- What is Niraj Madhani's NPI number?
- Niraj Madhani's National Provider Identifier (NPI) is 1891254868, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Niraj Madhani's specialty?
- Niraj Madhani is listed in the NPPES registry with a primary specialty of Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Niraj Madhani located?
- Niraj Madhani's practice location on file with NPPES is 200 W Arbor Dr, San Diego, CA 92103-9000.
- What is Niraj Madhani's phone number?
- The practice phone number listed in the NPPES registry for Niraj Madhani is (800) 926-8273.
- Does Niraj Madhani accept Medicare?
- Niraj Madhani is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Niraj Madhani's NPI active?
- Yes — Niraj Madhani's NPI (1891254868) is active in the NPPES registry as of the last update on 2022-06-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.