Active NPI 1528069952 Individual Practitioner Male Practitioner

Dr. Niraj Chimanbhai Mistry , MD

Internal Medicine • Elyria, OH

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Niraj Mistry, MD is a certified Internal Medicine practicing in Elyria, OH. With approximately 36 years of clinical experience since completing medical education in 1990, Dr. Mistry delivers high-quality medical care to the local community at 125 E BROAD ST.

Dr. Mistry is affiliated with University Primary Care Practices Inc and 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 straightforward level of medical decision making, per day, if using time, at least, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

125 E Broad St
Suite 202

Elyria, OH 440356400

Telephone 4403297306

Fax 4403297798

Associated Practice Facility / Clinic

🏢 Om Healthcare Llc Facility NPI 1205838067

Medicare Profile & Education

Medical School

Other

Graduation Year

1990

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Elyria, OH

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

36 Yrs +11.7 yrs vs City Avg

City Avg: 24.3 Yrs

State Avg: 26.9 Yrs

Regional Practice Density

24 Specialists

Practicing in Elyria, OH (5516 Statewide)

Telehealth Adoption Rate

16.7% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

52.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Mistry (36 Years) 36 Yrs

Elyria Specialty Average (24.3 Years) 24.3 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
99213 Established patient office or other outpatient visit, typically 15 minutes	536	281	$133.00	$71.89
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	437	139	$98.00	$71.11
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	258	258	$235.00	$51.54
99306 Initial nursing facility visit, typically 45 minutes per day	160	135	$228.00	$173.58
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	102	58	$130.00	$102.72
G0008 Administration of influenza virus vaccine	80	80	$44.00	$30.39
90662 Influenza vaccine split virus, preservative free	78	78	$67.00	$65.66
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	77	63	$187.00	$87.70
G0447 Face-to-face behavioral counseling for obesity, 15 minutes	33	33	$45.00	$24.33
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	28	28	$38.00	$15.87
99495 Transitional care management services for problem of at least moderate complexity	20	18	$302.00	$102.01
99496 Transitional care management services for problem of high complexity	20	18	$426.00	$110.42
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	20	18	$118.00	$50.80
93000 Routine ekg using at least 12 leads including interpretation and report	18	18	$72.00	$13.00
99406 Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes	17	17	$25.00	$14.02
99315 Nursing facility discharge day management, 30 minutes or less	11	11	$105.00	$78.27

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	565	293	$125.55	$72.59
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	387	130	$115.00	$77.45
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	293	104	$98.00	$72.17
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	228	228	$203.00	$48.70
99306 Initial nursing facility visit, typically 45 minutes per day	115	103	$228.00	$177.32
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	100	89	$223.00	$127.49
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	95	55	$98.00	$72.21
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	81	65	$175.00	$90.66
G0008 Administration of influenza virus vaccine	76	75	$44.04	$29.36
90662 Influenza vaccine split virus, preservative free	75	74	$67.00	$65.66
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	71	47	$130.00	$103.39
G0447 Face-to-face behavioral counseling for obesity, 15 minutes	31	31	$45.00	$24.94
99306 Initial nursing facility visit, typically 45 minutes per day	29	28	$228.00	$177.32
99221 Initial hospital inpatient care per day, typically 30 minutes	24	24	$159.00	$81.57
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	20	20	$256.00	$57.24
99406 Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes	17	17	$25.00	$14.37
99497 Advance care planning, first 30 minutes	16	16	$165.00	$21.38
99496 Transitional care management services for problem of high complexity	14	14	$426.00	$140.25
93000 Routine ekg using at least 12 leads including interpretation and report	13	13	$72.00	$13.87
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	13	13	$240.00	$160.14
99495 Transitional care management services for problem of at least moderate complexity	12	12	$302.00	$88.22
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	11	11	$118.00	$49.96

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	623	301	$127.95	$76.14
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	498	164	$98.00	$67.20
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	439	140	$115.00	$70.25
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	235	235	$203.00	$45.57
99306 Initial nursing facility visit, typically 45 minutes per day	190	171	$228.00	$161.69
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	148	130	$223.00	$133.44
G0008 Administration of influenza virus vaccine	82	82	$44.00	$27.97
90662 Influenza vaccine split virus, preservative free	81	81	$67.00	$65.65
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	59	48	$165.00	$78.27
G0447 Face-to-face behavioral counseling for obesity, 15 minutes	49	49	$45.00	$26.08
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	32	27	$130.00	$88.49
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	30	29	$118.00	$51.48
99406 Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes	22	22	$25.00	$15.15
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	20	20	$240.00	$152.19
99496 Transitional care management services for problem of high complexity	17	16	$426.00	$114.10
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	15	15	$323.00	$195.38
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	14	14	$256.00	$66.48

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	695	338	$106.00	$89.57
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	518	143	$98.00	$67.92
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	442	157	$115.00	$71.29
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	247	247	$203.00	$130.50
99306 Initial nursing facility visit, typically 45 minutes per day	170	141	$228.00	$164.37
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	154	141	$210.00	$135.01
G0008 Administration of influenza virus vaccine	77	77	$44.00	$16.19
90662 Influenza vaccine split virus, preservative free	75	75	$67.00	$65.20
G0447 Face-to-face behavioral counseling for obesity, 15 minutes	66	66	$45.00	$26.52
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	60	51	$157.00	$127.71
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	48	46	$118.00	$51.66
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	33	11	$49.00	$13.80
99406 Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes	25	25	$25.00	$15.41
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	23	20	$130.00	$89.49
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	22	22	$240.00	$166.01
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	17	17	$305.00	$198.60
99316 Nursing facility discharge management, more than 30 minutes	11	11	$150.00	$103.65

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	713	342	$102.93	$73.32
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	511	136	$98.00	$68.75
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	370	137	$115.00	$72.71
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	274	274	$203.00	$113.61
99306 Initial nursing facility visit, typically 45 minutes per day	145	124	$228.00	$166.59
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	110	97	$210.00	$138.76
99497 Advance care planning, first 30 minutes	84	84	$165.00	$85.80
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	83	68	$151.95	$106.80
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	78	65	$118.00	$52.15
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	64	62	$305.00	$203.03
G0008 Administration of influenza virus vaccine	59	59	$44.00	$16.06
90662 Influenza vaccine split virus, preservative free	58	58	$67.00	$60.77
G0447 Face-to-face behavioral counseling for obesity, 15 minutes	44	44	$45.00	$26.38
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	37	27	$130.00	$90.45
99335 Established patient assisted living visit, typically 25 minutes	30	18	$135.00	$95.24
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	27	27	$235.00	$162.17
99406 Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes	24	24	$25.00	$15.23
99336 Established patient assisted living visit, typically 40 minutes	15	15	$190.00	$133.74
82270 Stool analysis for blood to screen for colon tumors	12	12	$18.00	$4.37
93000 Routine ekg using at least 12 leads including interpretation and report	11	11	$72.00	$16.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,014	379	$100.00	$71.34
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	553	156	$94.00	$67.53
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	265	131	$115.00	$71.32
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	160	117	$150.00	$105.44
99306 Initial nursing facility visit, typically 45 minutes per day	156	131	$228.00	$164.26
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	84	79	$305.00	$197.44
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	78	72	$210.00	$135.36
G0008 Administration of influenza virus vaccine	62	61	$44.00	$15.75
90662 Influenza vaccine split virus, preservative free	54	53	$67.00	$54.84
99335 Established patient assisted living visit, typically 25 minutes	47	29	$135.00	$93.66
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	35	$118.00	$51.49
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	34	27	$130.00	$89.81
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	27	26	$185.00	$128.18
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	27	27	$203.00	$108.33
99336 Established patient assisted living visit, typically 40 minutes	27	21	$190.00	$133.58
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	23	23	$245.00	$159.44
93000 Routine ekg using at least 12 leads including interpretation and report	23	22	$72.00	$16.36
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	21	21	$235.00	$160.24
99316 Nursing facility discharge management, more than 30 minutes	15	15	$150.00	$104.09
82270 Stool analysis for blood to screen for colon tumors	13	13	$18.00	$4.29

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,108	398	$99.92	$69.49
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	435	119	$94.00	$67.39
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	250	129	$115.00	$71.32
99306 Initial nursing facility visit, typically 45 minutes per day	138	113	$228.00	$162.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	133	98	$149.85	$103.06
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	129	123	$305.00	$198.71
G0008 Administration of influenza virus vaccine	98	98	$44.00	$19.30
90662 Influenza vaccine split virus, preservative free	83	83	$67.00	$52.30
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	62	54	$118.00	$51.50
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	43	31	$30.00	$8.32
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	42	41	$210.00	$134.09
99335 Established patient assisted living visit, typically 25 minutes	40	25	$135.00	$92.58
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	36	28	$130.00	$89.03
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	24	24	$235.00	$159.88
99336 Established patient assisted living visit, typically 40 minutes	21	16	$190.00	$132.17
93000 Routine ekg using at least 12 leads including interpretation and report	21	19	$72.00	$16.19
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	18	18	$203.00	$111.79
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	16	16	$245.00	$154.73
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	13	13	$185.00	$127.24
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	11	11	$37.00	$16.95
99316 Nursing facility discharge management, more than 30 minutes	11	11	$150.00	$97.32

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,169	426	$95.00	$69.34
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	432	109	$93.44	$66.24
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	328	142	$115.00	$70.41
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	128	118	$305.00	$197.82
99306 Initial nursing facility visit, typically 45 minutes per day	109	95	$228.00	$159.51
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	90	72	$140.00	$100.08
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	66	57	$116.09	$51.39
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	47	45	$210.00	$133.62
99306 Initial nursing facility visit, typically 45 minutes per day	45	42	$220.80	$162.12
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	38	38	$235.00	$154.78
G0008 Administration of influenza virus vaccine	34	34	$44.00	$23.76
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	32	32	$37.00	$18.65
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	24	19	$89.88	$67.03
G0179 Physician re-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 to affirm the initial imp	22	11	$88.64	$39.35
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	20	18	$120.00	$88.41
99316 Nursing facility discharge management, more than 30 minutes	20	19	$135.00	$98.98
93000 Routine ekg using at least 12 leads including interpretation and report	15	15	$72.00	$16.13
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	15	15	$203.00	$110.51
99220 Hospital observation care, typically 70 minutes	13	12	$250.00	$181.25
99217 Hospital observation care on day of discharge	12	12	$125.00	$70.75
99239 Hospital discharge day management, more than 30 minutes	12	12	$165.00	$104.40

Medical Specialties & State Licenses

CMS Verified: 2022-10-05

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License OH 35-075487

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

2102450 (OH)

Hospital & Practice Group Affiliations

University Primary Care Practices Inc

11100 Euclid Ave, Cleveland, OH 441061716

University Primary Care Practices Inc

125 E Broad St, Elyria, OH 440356429

University Primary Care Practices Inc

125 E Broad St, Elyria, OH 440356447

Phone: 4403297310

University Primary Care Practices Inc

158 W Main Rd, Conneaut, OH 440302039

Practice Associates & Co-Workers

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

2 Associated Practitioners

Dr. Hemendra Mehta , MD

Internal Medicine

NPI 1386645729

Doctor of Medicine (M.D.)

Dr. Harmohinder Dhillon , MD

Internal Medicine

NPI 1578552568

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 March 24, 2014

NPI status registered as active in NPPES database

📍

Updated Practice Location March 24, 2014

Registered at 125 E BROAD ST, SUITE 202, ELYRIA, OH 440356400 (Tel: 4403297306)

📍

Updated Business Mailing Address March 24, 2014

Registered at 125 E BROAD ST, STE 202, ELYRIA, OH 440356400 (Tel: 4403297305)

👤

Provider Name / Credentials Updated March 24, 2014

Recorded as NIRAJ MISTRY, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 24, 2014

Internal Medicine (License #35-075487 in OH)

🟢

Initial NPI Registration & Enumeration August 09, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1528069952

Entity Type:

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

Enumeration Date: August 09, 2005

Last Update: October 05, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

125 E Broad St, Ste 202

Elyria, OH 440356400

Phone: 4403297305

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.