Doctor profile · Federal record
Dr. Pratibha Rao, MD
General Practice Physician (CMS: Hospitalist) · Internal Medicine Physician · Hospitalist Physician · Montclair, NJ
- NPI 1346231263
- Accepts Medicare
- MIPS 96.8 / 100 · 2023
- 32 yrs in practice
- Female
- No sanctions
Practice & contact
- Primary practice
-
1 Bay Ave
Montclair, NJ 070424837
(973) 429-6000 - Mailing address
-
66 West Gilbert Street
Red Bank, NJ 077014918
Credentials & registration
- NPI registered
- October 2005 — 21 yrs on file
- Profile last updated
- September 11, 2025
- Year of graduation
- 1994 — 32 yrs since
- Specialty taxonomy
- 208D00000X — NUCC code
- State license (1)
- New Jersey #25MA07823300
- Medicaid
- NJ #0075825
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1346231263. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
879
Distinct HCPCS
7
Medicare allowed
$113,340
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
99232 |
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 237 | 125 | $85 | |
99222 |
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 218 | 216 | $140 | |
99223 |
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 215 | 208 | $186 | |
99233 |
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 74 | 63 | $130 | |
99239 |
Hospital discharge day management, more than 30 minutes | 72 | 69 | $124 | |
99231 |
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 44 | 28 | $54 | |
99238 |
Hospital discharge day management, 30 minutes or less | 19 | 19 | $89 |
In context: peer comparison
Among 2 peers in Montclair General Practice Physician, average services per provider: 112. This provider delivers 7.8× the peer median.Medicare Part D · 2023
Top prescriptions
Total claims
12
Patients
11
Total drug cost
$165
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Pantoprazole Sodium | Generic | 12 | 11 | $165 |
Frequently asked questions
What is Dr. Pratibha Rao's medical specialty?
Dr. Pratibha Rao practices General Practice Physician in Montclair, NJ.
Where does Dr. Pratibha Rao practice?
Dr. Pratibha Rao practices at 1 Bay Ave, Montclair, NJ 070424837. Office phone: 9734296000.
What is Dr. Pratibha Rao's NPI?
Dr. Pratibha Rao's National Provider Identifier (NPI) is 1346231263, issued by NPPES.
Does Dr. Pratibha Rao accept Medicare assignment?
Yes. Dr. Pratibha Rao accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Pratibha Rao commonly perform?
Top Medicare-reported procedures in 2023: Subsequent hospital care with moderate levelof medical decision making (HCPCS 99232); Initial hospital care with straightforward or low-level medical decision making (HCPCS 99222); Initial hospital care with moderate level of medical decision making (HCPCS 99223). Source: CMS Medicare Physician & Other Practitioners file.