Nishita Nigam, MD
Hospitalist · San Jose
- Medicare standing
- Clear
- Enrolled, allowed to bill and order, not excluded
- Plans that list them
- 1
- 1 carrier
- Office
- 1
Offices
1 location · County of Santa Clara · 1,000 clinicians in this group
Plans that list them
1 plan · 1 carrier
A missing listing does not mean out of network. Directories change, and a listing does not cover every office. Call Dr. Nigam’s office at (408) 885-5000 to confirm they take your plan. Ask about the office you use, its medical group, referrals and appointments.
| DualConnect (HMO D-SNP) | Santa Clara Family Health Plan | Listed | Sep 1, 2026 |
Original Medicare doctor bills
$69,268
Medicare paid this office $69,268 for 274 people.
This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 196 | $32,117 | $71 |
| Subsequent hospital care with moderate levelof medical decision making at least 50 minutes | 90 | $15,002 | $106 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 55 | $8,531 | $152 |
| Hospital discharge day management, more than 30 minutes | 74 | $7,867 | $105 |
| Hospital discharge day management, 30 minutes or less | 41 | $3,199 | $74 |
See all 6 services
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 196 | $32,117 | $71 |
| Subsequent hospital care with moderate levelof medical decision making at least 50 minutes | 90 | $15,002 | $106 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 55 | $8,531 | $152 |
| Hospital discharge day management, more than 30 minutes | 74 | $7,867 | $105 |
| Hospital discharge day management, 30 minutes or less | 41 | $3,199 | $74 |
| Advance care planning, first 30 minutes | 34 | $2,318 | $68 |
Who their Medicare patients are
274 Original Medicare patients in 2024. Average age 77 · Under 65 11% · 85 and older 26% · Women 52% · Also on Medicaid 75% · Health risk score 2.50. Above the middle of the specialty; the typical hospitalist clinician is at 2.49.
Conditions among them: High blood pressure 75% · Diabetes 66% · Chronic kidney disease 45% · Coronary heart disease 43% · Heart failure 41% · Dementia 39% · Atrial fibrillation 31% · COPD 28% · Depression 26% · Stroke 26% · Cancer 14%.
The office billed $280,454, Medicare allowed $87,201 and paid $69,268; for 807 services of 8 kinds.
Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.
Year by year
| 2024 | 274 | 807 | 77 | 2.50 | $280,454 | $69,268 |
| 2023 | 155 | 379 | 76 | 3.27 | $157,084 | $33,803 |
| 2022 | 167 | 389 | 73 | 2.72 | $223,325 | $36,495 |
| 2021 | 157 | 375 | 72 | 2.81 | $199,255 | $32,989 |
| 2020 | 53 | 103 | 70 | 2.35 | $58,486 | $10,404 |
Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.
See the services billed each year
2023: 6 services
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 89 | $13,065 | $71 |
| Subsequent hospital care with moderate levelof medical decision making at least 50 minutes | 53 | $9,383 | $108 |
| Hospital discharge day management, more than 30 minutes | 39 | $3,982 | $102 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 25 | $3,940 | $158 |
| Hospital discharge day management, 30 minutes or less | 20 | $1,507 | $75 |
| Advance care planning, first 30 minutes | 16 | $1,115 | $70 |
2022: 4 services
| Subsequent hospital care with moderate levelof medical decision making at least 50 minutes | 82 | $16,643 | $90 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 51 | $9,427 | $175 |
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 44 | $6,559 | $63 |
| Hospital discharge day management, more than 30 minutes | 22 | $2,084 | $95 |
2021: 5 services
| Subsequent hospital care with moderate levelof medical decision making at least 50 minutes | 80 | $14,974 | $90 |
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 50 | $7,768 | $61 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 30 | $5,369 | $179 |
| Hospital discharge day management, more than 30 minutes | 26 | $2,512 | $97 |
| Initial hospital care with straightforward or low-level medical decision making at least 55 minutes | 15 | $1,712 | $114 |
2020: 2 services
| Subsequent hospital care with moderate levelof medical decision making at least 50 minutes | 29 | $4,362 | $95 |
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 17 | $3,122 | $184 |
Medicaid work
$12,853 in 2024
Medicaid paid $12,853 for 741 billed services this clinician did in 2024, up to 37 people in a month for one service.
Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.
| SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES | 553 | $8,729 |
| SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES | 97 | $1,942 |
| Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter | 59 | $1,157 |
| Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surrogate | 16 | $633 |
| 1ST HOSP IP/OBS HIGH 75 | 16 | $392 |
| 2024 | 741 | 5 | 37 | $12,853 |
| 2023 | 353 | 4 | 33 | $13,138 |
| 2021 | 63 | 1 | 20 | $4,519 |
See the largest Medicaid services in earlier years
2023
| SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES | 282 | $10,105 |
| SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES | 31 | $2,624 |
| Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter | 26 | $207 |
| Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter | 14 | $203 |
2021
| SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES | 63 | $4,519 |
Drugs they prescribed that Part D paid
$18,117
Pharmacies billed $18,117 in 2024.
This is pharmacy cost, not the office bill, and not what patients paid.
209 generic and 41 brand-name prescriptions · $18,117 in drug cost · 31 antibiotic prescriptions to 25 people.
Part D prescriptions only. The opioid rate is opioid prescriptions as a share of all this clinician's Part D prescriptions; surgeons and pain specialists run higher than others, so it is shown against the same specialty.
| Eliquis | 15 | $9,194 | $613 |
| Prednisone | 16 | $56 | $3 |
| Atorvastatin | 18 | $42 | $2 |
| Metoprolol | 13 | $19 | $1 |
| Furosemide | 12 | $15 | $1 |
Year by year
| 2024 | 250 | 97 | None | 16% | $18,117 |
| 2023 | 133 | 59 | None | 10% | $24,986 |
| 2022 | 121 | 28 | None | 9% | $5,136 |
| 2021 | 145 | 38 | None | 17% | $13,670 |
| 2020 | 42 | 14 | None | None | $6,125 |
Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.
Professional record
- NPI
- 1093244774
- Gender
- Female
More record details
- Sole proprietor
- No
- Taxonomy
- Internal medicine (207R00000X)
- Mailing address
- 225 N Jackson Ave, San Jose, CA, 95116
- NPI first listed
- 2017-06-07
- NPI last updated
- 2026-03-25
- NPI record certified
- 2026-03-25
This is when the NPI record was last certified, not a medical board exam.