Active NPI 1124078142 Individual Practitioner Male Practitioner

Dr. Sanjay Kavathia , MD

Internal Medicine • Hackettstown, NJ

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Sanjay Kavathia, MD is a certified Internal Medicine practicing in Hackettstown, NJ. With approximately 32 years of clinical experience since completing medical education in 1994, Dr. Kavathia delivers high-quality medical care to the local community at 616 WILLOW GROVE ST.

Dr. Kavathia accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least, subsequent hospital care with moderate levelof medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

616 Willow Grove St
Unit 1a

Hackettstown, NJ 078401779

Telephone 9088528484

Fax 9088524197

Associated Practice Facility / Clinic

🏢 Obstetrics And Gynecology Associates, P.a. Facility NPI 1164573465

Medicare Profile & Education

Medical School

Other

Graduation Year

1994

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Hackettstown, NJ

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

32 Yrs +6.4 yrs vs City Avg

City Avg: 25.6 Yrs

State Avg: 30.1 Yrs

Regional Practice Density

27 Specialists

Practicing in Hackettstown, NJ (4957 Statewide)

Telehealth Adoption Rate

25.9% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

15.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Kavathia (32 Years) 32 Yrs

Hackettstown Specialty Average (25.6 Years) 25.6 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	771	240	$146.27	$140.16
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	488	108	$150.00	$115.58
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	394	73	$150.00	$125.13
99441 Telephone medical discussion with physician, 5-10 minutes	390	187	$52.14	$51.28
36415 Insertion of needle into vein for collection of blood sample	297	192	$3.00	$2.94
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	270	85	$85.22	$80.10
99349 Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes	246	35	$175.00	$135.83
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	225	166	$203.23	$196.92
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	218	148	$19.95	$17.55
99497 Advance care planning, first 30 minutes	217	213	$95.00	$88.46
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	189	189	$155.00	$141.86
90661 Influenza vaccine, trivalent derived from cell cultures	166	165	$50.00	$36.11
G0008 Administration of influenza virus vaccine	165	163	$49.97	$35.50
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	154	25	$100.00	$68.17
99213 Established patient office or other outpatient visit, typically 15 minutes	145	102	$103.55	$99.55
99439 Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month	131	24	$75.00	$52.46
99306 Initial nursing facility visit, typically 45 minutes per day	131	96	$185.11	$181.76
99496 Transitional care management services for problem of high complexity	121	94	$315.86	$201.87
99496 Transitional care management services for problem of high complexity	113	81	$315.86	$306.86
99239 Hospital discharge day management, more than 30 minutes	108	69	$165.00	$121.67
99497 Advance care planning, first 30 minutes	106	85	$95.00	$80.16
99315 Nursing facility discharge day management, 30 minutes or less	65	56	$80.00	$78.72
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	63	43	$225.00	$183.26
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	48	23	$125.00	$82.91
99495 Transitional care management services for problem of at least moderate complexity	45	43	$233.37	$227.33
99291 Critical care, first 30-74 minutes	41	33	$312.31	$223.14
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	37	35	$65.14	$59.13
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	33	33	$188.21	$182.25
99442 Telephone medical discussion with physician, 11-20 minutes	28	27	$75.00	$73.80
93000 Routine ekg using at least 12 leads including interpretation and report	20	20	$16.93	$15.77
G2212 Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or	19	17	$34.34	$33.85

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99441 Telephone medical discussion with physician, 5-10 minutes	1,283	394	$52.18	$51.48
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	851	263	$146.83	$140.41
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	480	92	$125.68	$117.25
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	471	119	$115.49	$104.99
36415 Insertion of needle into vein for collection of blood sample	389	219	$3.09	$2.92
99349 Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes	369	46	$176.03	$138.32
99213 Established patient office or other outpatient visit, typically 15 minutes	228	132	$103.85	$99.35
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	221	46	$99.89	$68.82
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	200	79	$85.00	$81.22
99497 Advance care planning, first 30 minutes	199	197	$95.00	$89.98
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	186	138	$204.49	$193.71
99439 Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month	184	42	$74.86	$52.10
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	184	184	$54.51	$33.26
G0008 Administration of influenza virus vaccine	182	182	$45.00	$33.97
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	179	179	$155.00	$143.25
99239 Hospital discharge day management, more than 30 minutes	135	90	$135.00	$120.65
99306 Initial nursing facility visit, typically 45 minutes per day	133	108	$185.10	$182.84
99496 Transitional care management services for problem of high complexity	111	76	$317.38	$306.02
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	85	34	$92.43	$79.75
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	71	53	$225.00	$187.16
99315 Nursing facility discharge day management, 30 minutes or less	62	58	$80.00	$79.21
99442 Telephone medical discussion with physician, 11-20 minutes	58	46	$75.00	$74.23
99291 Critical care, first 30-74 minutes	56	42	$312.31	$228.76
99495 Transitional care management services for problem of at least moderate complexity	45	41	$233.37	$227.87
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	43	43	$65.14	$58.49
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	33	33	$188.21	$184.03
93000 Routine ekg using at least 12 leads including interpretation and report	18	18	$17.93	$15.35

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99441 Telephone medical discussion with physician, 5-10 minutes	1,578	432	$52.06	$51.92
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	958	280	$146.18	$143.66
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	595	123	$101.64	$99.87
36415 Insertion of needle into vein for collection of blood sample	437	261	$3.11	$2.96
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	435	87	$112.24	$111.38
99336 Established patient assisted living visit, typically 40 minutes	399	50	$148.13	$147.45
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	361	81	$100.00	$70.93
99213 Established patient office or other outpatient visit, typically 15 minutes	343	171	$103.37	$102.60
99497 Advance care planning, first 30 minutes	224	221	$95.07	$93.67
99439 Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month	208	60	$74.88	$52.71
G0008 Administration of influenza virus vaccine	206	203	$30.00	$29.28
90756 Vaccine for influenza for injection into muscle	206	203	$44.47	$29.77
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	203	203	$155.00	$148.19
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	152	120	$203.28	$200.87
99306 Initial nursing facility visit, typically 45 minutes per day	142	110	$184.61	$179.93
99239 Hospital discharge day management, more than 30 minutes	127	83	$120.04	$115.36
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	95	43	$78.07	$77.48
99496 Transitional care management services for problem of high complexity	88	63	$315.86	$316.15
99315 Nursing facility discharge day management, 30 minutes or less	65	59	$80.00	$79.35
99495 Transitional care management services for problem of at least moderate complexity	63	51	$233.63	$230.19
99291 Critical care, first 30-74 minutes	58	45	$312.18	$235.88
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	56	51	$225.00	$215.30
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	47	47	$188.25	$184.78
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	42	23	$85.71	$75.37
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	36	34	$65.14	$60.41
93000 Routine ekg using at least 12 leads including interpretation and report	25	22	$16.93	$16.41
97597 Removal of tissue from wound, 20.0 sq cm or less	16	11	$89.93	$89.69

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99441 Telephone medical discussion with physician, 5-10 minutes	1,198	387	$52.02	$52.50
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	984	270	$145.40	$146.67
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	555	104	$101.77	$101.37
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	432	89	$112.44	$112.78
99213 Established patient office or other outpatient visit, typically 15 minutes	420	198	$102.89	$103.24
36415 Insertion of needle into vein for collection of blood sample	404	239	$3.06	$2.99
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	371	69	$59.95	$46.34
99336 Established patient assisted living visit, typically 40 minutes	336	43	$148.12	$149.73
99439 Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month	214	47	$58.60	$42.48
99497 Advance care planning, first 30 minutes	209	205	$94.82	$94.81
G0008 Administration of influenza virus vaccine	205	201	$29.82	$19.51
90756 Vaccine for influenza for injection into muscle	196	195	$30.00	$28.37
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	176	176	$153.76	$150.82
99239 Hospital discharge day management, more than 30 minutes	132	97	$120.07	$117.07
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	128	55	$78.66	$78.95
99306 Initial nursing facility visit, typically 45 minutes per day	127	103	$184.62	$183.95
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	102	83	$202.86	$203.23
99496 Transitional care management services for problem of high complexity	65	52	$314.67	$318.23
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	60	52	$224.88	$219.98
99315 Nursing facility discharge day management, 30 minutes or less	54	53	$80.15	$80.87
99291 Critical care, first 30-74 minutes	50	39	$312.16	$236.46
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	34	34	$188.09	$189.93
99495 Transitional care management services for problem of at least moderate complexity	27	24	$231.27	$228.24
93000 Routine ekg using at least 12 leads including interpretation and report	27	25	$18.01	$17.11
97597 Removal of tissue from wound, 20.0 sq cm or less	23	13	$89.67	$90.67
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	22	21	$65.14	$60.76
99337 Established patient assisted living visit, typically 60 minutes	18	18	$211.70	$214.12
99442 Telephone medical discussion with physician, 11-20 minutes	15	14	$84.85	$85.77
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	11	11	$30.00	$29.49

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99441 Telephone medical discussion with physician, 5-10 minutes	1,745	414	$47.93	$48.53
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,135	288	$122.60	$123.48
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	651	146	$101.68	$102.16
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	641	104	$59.67	$46.95
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	563	114	$114.70	$115.31
99213 Established patient office or other outpatient visit, typically 15 minutes	558	246	$84.90	$83.63
G2058 Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure). (do not report g2058 fo	294	76	$60.00	$42.49
99336 Established patient assisted living visit, typically 40 minutes	258	42	$149.19	$150.41
G0008 Administration of influenza virus vaccine	222	219	$29.80	$19.04
99497 Advance care planning, first 30 minutes	184	183	$93.66	$94.34
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	183	79	$78.95	$77.33
99239 Hospital discharge day management, more than 30 minutes	172	118	$118.75	$118.94
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	168	168	$130.98	$132.36
99306 Initial nursing facility visit, typically 45 minutes per day	153	123	$184.59	$185.91
90756 Vaccine for influenza for injection into muscle	147	147	$30.00	$27.70
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	134	104	$164.12	$165.44
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	122	57	$79.89	$80.20
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic	114	87	$16.13	$16.05
99496 Transitional care management services for problem of high complexity	106	69	$277.01	$274.94
99315 Nursing facility discharge day management, 30 minutes or less	97	94	$81.48	$81.99
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	84	65	$222.58	$221.92
99335 Established patient assisted living visit, typically 25 minutes	83	35	$105.74	$106.79
99291 Critical care, first 30-74 minutes	76	61	$311.61	$244.09
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	64	64	$30.00	$29.10
36415 Insertion of needle into vein for collection of blood sample	56	51	$3.21	$2.94
99442 Telephone medical discussion with physician, 11-20 minutes	55	43	$83.04	$84.13
99441 Telephone medical discussion with physician, 5-10 minutes	48	32	$24.67	$21.32
99495 Transitional care management services for problem of at least moderate complexity	45	43	$208.21	$209.63
93000 Routine ekg using at least 12 leads including interpretation and report	31	30	$19.55	$19.71
97597 Removal of tissue from wound, 20.0 sq cm or less	29	17	$89.93	$90.82
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	23	22	$65.14	$60.82
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	22	22	$184.25	$184.98
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	11	11	$30.00	$19.58
99220 Hospital observation care, typically 70 minutes	11	11	$203.29	$205.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,291	327	$121.47	$120.80
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	943	152	$60.00	$46.16
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	673	123	$114.17	$112.86
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	657	145	$101.56	$100.41
99213 Established patient office or other outpatient visit, typically 15 minutes	313	145	$82.98	$82.64
G0008 Administration of influenza virus vaccine	241	234	$29.80	$18.67
90756 Vaccine for influenza for injection into muscle	219	212	$30.00	$25.97
99497 Advance care planning, first 30 minutes	211	205	$93.61	$93.28
99239 Hospital discharge day management, more than 30 minutes	187	125	$119.11	$117.35
99336 Established patient assisted living visit, typically 40 minutes	177	38	$148.92	$148.01
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	174	130	$162.39	$160.71
99306 Initial nursing facility visit, typically 45 minutes per day	173	132	$183.58	$181.16
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	162	162	$132.23	$130.38
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	145	75	$79.82	$78.99
36415 Insertion of needle into vein for collection of blood sample	130	100	$3.09	$2.94
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	129	82	$76.95	$75.68
99496 Transitional care management services for problem of high complexity	118	84	$262.09	$259.11
99315 Nursing facility discharge day management, 30 minutes or less	94	82	$80.51	$79.21
99335 Established patient assisted living visit, typically 25 minutes	93	34	$104.29	$103.88
99291 Critical care, first 30-74 minutes	87	67	$303.81	$238.66
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	68	56	$222.03	$219.65
99495 Transitional care management services for problem of at least moderate complexity	49	40	$185.41	$183.98
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	45	45	$183.45	$182.21
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	33	31	$65.14	$59.74
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	27	27	$193.32	$191.21
93000 Routine ekg using at least 12 leads including interpretation and report	27	26	$19.96	$19.30
99220 Hospital observation care, typically 70 minutes	25	20	$203.88	$201.51
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	22	22	$30.00	$27.57
99217 Hospital observation care on day of discharge	13	12	$80.74	$80.05
99285 Emergency department visit for life threatening or functioning severity	12	11	$185.75	$184.93

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,403	340	$120.81	$114.79
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	948	144	$114.10	$108.91
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	882	251	$60.00	$45.03
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	752	143	$101.38	$96.82
99213 Established patient office or other outpatient visit, typically 15 minutes	316	160	$82.04	$78.37
36415 Insertion of needle into vein for collection of blood sample	247	171	$3.15	$2.93
99306 Initial nursing facility visit, typically 45 minutes per day	239	158	$183.55	$175.20
90756 Vaccine for influenza for injection into muscle	232	231	$30.00	$22.23
G0008 Administration of influenza virus vaccine	230	227	$29.80	$23.23
99239 Hospital discharge day management, more than 30 minutes	223	137	$119.04	$113.59
99497 Advance care planning, first 30 minutes	223	215	$93.65	$89.13
99336 Established patient assisted living visit, typically 40 minutes	197	50	$148.91	$142.32
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	190	102	$79.68	$76.05
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	188	188	$132.30	$125.69
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	182	134	$162.37	$152.93
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	146	80	$76.84	$73.28
99335 Established patient assisted living visit, typically 25 minutes	135	38	$104.29	$99.57
99315 Nursing facility discharge day management, 30 minutes or less	123	107	$80.48	$76.76
99291 Critical care, first 30-74 minutes	112	84	$303.81	$230.79
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	99	79	$222.02	$210.36
99496 Transitional care management services for problem of high complexity	97	76	$262.09	$250.17
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	56	54	$65.14	$58.04
99495 Transitional care management services for problem of at least moderate complexity	46	42	$185.07	$177.28
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	43	43	$183.47	$175.54
99220 Hospital observation care, typically 70 minutes	41	36	$203.88	$194.65
93000 Routine ekg using at least 12 leads including interpretation and report	31	30	$19.38	$18.52
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	30	13	$29.68	$22.63
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	23	23	$193.26	$183.77
99219 Hospital observation care, typically 50 minutes	21	17	$148.88	$142.10
99217 Hospital observation care on day of discharge	19	18	$80.74	$77.07
99285 Emergency department visit for life threatening or functioning severity	15	15	$185.75	$177.30

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,270	323	$120.26	$118.23
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	844	149	$101.34	$99.39
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	740	154	$114.41	$112.33
99336 Established patient assisted living visit, typically 40 minutes	323	52	$148.18	$145.91
99213 Established patient office or other outpatient visit, typically 15 minutes	295	141	$82.02	$80.76
G0008 Administration of influenza virus vaccine	234	232	$29.80	$28.89
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	230	230	$30.00	$23.47
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	221	163	$161.31	$158.21
99239 Hospital discharge day management, more than 30 minutes	196	141	$118.91	$116.68
99306 Initial nursing facility visit, typically 45 minutes per day	191	141	$183.13	$179.71
99497 Advance care planning, first 30 minutes	187	185	$93.66	$88.60
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	149	77	$82.25	$77.71
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	134	134	$130.89	$128.27
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	132	80	$77.95	$75.11
99315 Nursing facility discharge day management, 30 minutes or less	115	101	$80.83	$79.55
99496 Transitional care management services for problem of high complexity	83	70	$261.46	$255.64
99291 Critical care, first 30-74 minutes	81	66	$301.62	$237.96
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	78	68	$222.13	$217.55
99335 Established patient assisted living visit, typically 25 minutes	68	34	$104.29	$102.64
99220 Hospital observation care, typically 70 minutes	54	45	$203.19	$200.06
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	45	45	$182.54	$180.06
99219 Hospital observation care, typically 50 minutes	41	29	$145.28	$142.95
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	39	38	$65.14	$59.84
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	38	38	$192.03	$188.19
99495 Transitional care management services for problem of at least moderate complexity	36	33	$183.81	$176.83
99217 Hospital observation care on day of discharge	33	32	$80.34	$79.05
36415 Insertion of needle into vein for collection of blood sample	30	29	$3.00	$2.94
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	29	17	$29.68	$29.14
93000 Routine ekg using at least 12 leads including interpretation and report	22	19	$19.38	$19.09
99496 Transitional care management services for problem of high complexity	17	17	$260.00	$172.31
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg	12	11	$30.00	$5.68
99285 Emergency department visit for life threatening or functioning severity	12	11	$186.49	$183.51

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License NJ 25MA07267000

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.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

State License NJ MA072670

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

8684308 (NJ)

Commercial Insurance / Payer ID Oxford

P2530863 (NJ)

Commercial Insurance / Payer ID United Healthcare

0228763 (NJ)

Commercial Insurance / Payer ID Gp10

AMERIGROUP (NJ)

Commercial Insurance / Payer ID Railroad Medicare

DC6255 (NJ)

Commercial Insurance / Payer ID Aetna Hmo

000133641 (NJ)

Commercial Insurance / Payer ID Aetna Ppo

2619378 (NJ)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners

Dr. Richard Anscher , MD

Specialist

NPI 1215088869

Doctor of Medicine (M.D.)

Karen Carrigan , CNM

Midwife

NPI 1215174925

Certified Nurse Midwife

Dr. Frank Salvatore , MD

Urology

NPI 1215908611

Doctor of Medicine (M.D.)

Dr. Neil Smith , MD

Specialist

NPI 1265583108

Doctor of Medicine (M.D.)

Dr. Narenderan Rajan , DMD

Dentist - General Practice

NPI 1275714255

Doctor of Dental Medicine

Dr. Matthew Hall , MD

Urology

NPI 1356509319

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active February 05, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location February 05, 2015

Registered at 616 WILLOW GROVE ST, UNIT 1A, HACKETTSTOWN, NJ 078401779 (Tel: 9088528484)

📍

Updated Business Mailing Address February 05, 2015

Registered at 616 WILLOW GROVE ST, UNIT 1A, HACKETTSTOWN, NJ 078401779 (Tel: 9088528484)

👤

Provider Name / Credentials Updated February 05, 2015

Recorded as SANJAY KAVATHIA, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 05, 2015

Internal Medicine (License #25MA07267000 in NJ)

🟢

Initial NPI Registration & Enumeration May 11, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1124078142

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: May 11, 2006

Last Update: February 05, 2015

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

616 Willow Grove St, Unit 1a

Hackettstown, NJ 078401779

Phone: 9088528484

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.