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Niraj L Sehgal, MD

Internal Medicine · Stanford

NPI 1447213160

Medicare standing
Clear
Enrolled, allowed to bill and order, not excluded
Plans that list them
5
2 carriers
Office
1
Since medical school
28 years
Rush Medical College of Rush University, 1998

Offices

1 location · Stanford Health Care · 3,152 clinicians in this group

Looking this up.

Hospitals listed: Stanford Health Care. That is not proof they admit you there this week.

Plans that list them

5 plans · 2 carriers

A missing listing does not mean out of network. Directories change, and a listing does not cover every office. Call Dr. Sehgal’s office at (650) 723-4000 to confirm they take your plan. Ask about the office you use, its medical group, referrals and appointments.

5 of 5 plans

Plans whose provider directory lists this clinician
SCAN Balance (HMO C-SNP)SCAN Health PlanListedOct 3, 2026
SCAN Classic (HMO)SCAN Health PlanListedOct 3, 2026
SCAN MyChoice (HMO)SCAN Health PlanListedOct 3, 2026
SCAN Strive (HMO C-SNP)SCAN Health PlanListedOct 3, 2026
DualConnect (HMO D-SNP)Santa Clara Family Health PlanListedSep 1, 2026

California Medical Board record

Licence A69329 · Current

Licensed to practise in California · since 1999 · expires 2028-12-31 · Rush Medical College of Rush University.

No disciplinary actions, convictions, malpractice judgments or citations in this record.

School, training and certification

What this clinician told their state board, medical school and everything before it. Only some states publish this, so nothing here means the state does not say, not that there was no training or certification.

Specialty certification

  • American Board of Internal Medicine - Internal Medicine

Checkups this office reported

Medicare did not publish checkup rates for this clinician.

Medicare’s overall office score
76.5 / 100
Scores the office’s reporting and systems. It is not a grade for how the doctor treats you.

Hospitals they work in

1 hospital

These rate the hospital, not this clinician. Most measures at most hospitals are no different from the national rate.

  • Stanford Health CareStanford, CAAcute Care Hospital · Voluntary non-profit - Private · Has an emergency departmentPart of Stanford Health Care, which runs 3 hospitalsHome of Stanford Cancer Institute, a National Cancer Institute designated comprehensive cancer centrePatients rate it 4 of 5 · 83% would definitely recommend it
    Overall rating: 5 of 5 starsWorse than the national rate — Perioperative pulmonary embolism or deep vein thrombosis rate: 5.31 (4.24 to 6.37) · 8,661 cases, Jul 2022 – Jun 2024Worse than the national rate — Rate of inpatient admissions for patients receiving outpatient chemotherapy: 14.1 (12.7 to 15.7) · 2,191 cases, Jan 2024 – Dec 2024Better than the national rate — Postoperative respiratory failure rate: 4.08 (1.95 to 6.21) · 5,296 cases, Jul 2022 – Jun 2024Better than the national rate — Catheter Associated Urinary Tract Infections (ICU + select Wards): 0.317, Oct 2024 – Sep 2025Better than the national rate — Clostridium Difficile (C.Diff): 0.446, Oct 2024 – Sep 2025Better than the national rate — SSI - Colon Surgery: 0.241, Oct 2024 – Sep 2025Better than the national rate — Ratio of unplanned hospital visits after hospital outpatient surgery: 0.7 (0.6 to 0.9) · 3,348 cases, Jan 2024 – Dec 2024
See every measure and the patient survey for Stanford Health Care

Behind the star rating — Deaths: 5 better, 3 the same, 0 worse of 8 measures. Safety: 3 better, 5 the same, 0 worse of 8 measures. Readmissions: 2 better, 5 the same, 4 worse of 11 measures. The star rating is worked out from an earlier period than the measures below, so the two can disagree.

Every scored measure at Stanford Health Care
Perioperative pulmonary embolism or deep vein thrombosis rateComplications and deaths5.31 (4.24 to 6.37) · 8,661 casesWorseJul 2022 – Jun 2024
Rate of inpatient admissions for patients receiving outpatient chemotherapyUnplanned return visits14.1 (12.7 to 15.7) · 2,191 casesWorseJan 2024 – Dec 2024
Postoperative respiratory failure rateComplications and deaths4.08 (1.95 to 6.21) · 5,296 casesBetterJul 2022 – Jun 2024
Catheter Associated Urinary Tract Infections (ICU + select Wards)Infections0.317BetterOct 2024 – Sep 2025
Clostridium Difficile (C.Diff)Infections0.446BetterOct 2024 – Sep 2025
SSI - Colon SurgeryInfections0.241BetterOct 2024 – Sep 2025
Ratio of unplanned hospital visits after hospital outpatient surgeryUnplanned return visits0.7 (0.6 to 0.9) · 3,348 casesBetterJan 2024 – Dec 2024
Abdominopelvic accidental puncture or laceration rateComplications and deaths1.06 (0.45 to 1.67) · 5,374 casesNo differentJul 2022 – Jun 2024
CMS Medicare PSI 90: Patient safety and adverse events compositeComplications and deaths0.86 (0.72 to 1)No differentJul 2022 – Jun 2024
Death rate among surgical inpatients with serious treatable complicationsComplications and deaths166.09 (137.88 to 194.3) · 470 casesNo differentJul 2022 – Jun 2024
Death rate for CABG surgery patientsComplications and deaths1.1 · 192 casesNoneJul 2022 – Jun 2025
Death rate for COPD patientsComplications and deaths6.4 · 146 casesNoneJul 2022 – Jun 2025
Death rate for heart attack patientsComplications and deaths9.7 · 253 casesNoneJul 2022 – Jun 2025
Death rate for heart failure patientsComplications and deaths6.3 · 880 casesNoneJul 2022 – Jun 2025
Death rate for pneumonia patientsComplications and deaths10.3 · 935 casesNoneJul 2022 – Jun 2025
Death rate for stroke patientsComplications and deaths8.7 · 501 casesNoneJul 2023 – Jun 2025
Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateComplications and deaths2.1 · 7,730 casesNoneJul 2024 – Jun 2025
Iatrogenic pneumothorax rateComplications and deaths0.13 (0 to 0.27) · 20,799 casesNo differentJul 2022 – Jun 2024
In-hospital fall-associated fracture rateComplications and deaths0.28 (0.14 to 0.43) · 23,182 casesNo differentJul 2022 – Jun 2024
Postoperative acute kidney injury requiring dialysis rateComplications and deaths0.94 (0.2 to 1.68) · 5,694 casesNo differentJul 2022 – Jun 2024
Postoperative hemorrhage or hematoma rateComplications and deaths2.36 (1.54 to 3.19) · 7,846 casesNo differentJul 2022 – Jun 2024
Postoperative sepsis rateComplications and deaths5.2 (3.76 to 6.64) · 5,603 casesNo differentJul 2022 – Jun 2024
Postoperative wound dehiscence rateComplications and deaths1.38 (0.23 to 2.53) · 2,211 casesNo differentJul 2022 – Jun 2024
Pressure ulcer rateComplications and deaths0.52 (0.21 to 0.83) · 19,915 casesNo differentJul 2022 – Jun 2024
Rate of complications for hip/knee replacement patientsComplications and deaths3.6 · 416 casesNoneApr 2023 – Mar 2025
Central Line Associated Bloodstream Infection (ICU + select Wards)Infections0.869No differentOct 2024 – Sep 2025
MRSA BacteremiaInfections0.857No differentOct 2024 – Sep 2025
SSI - Abdominal HysterectomyInfections0.368No differentOct 2024 – Sep 2025
Acute Myocardial Infarction (AMI) 30-Day Readmission RateUnplanned return visits16.2 · 247 casesNoneJul 2023 – Jun 2025
Heart failure (HF) 30-Day Readmission RateUnplanned return visits20.5 · 1,021 casesNoneJul 2023 – Jun 2025
Hospital return days for heart attack patientsUnplanned return visits47.8 · 258 casesNoneJul 2022 – Jun 2025
Hospital return days for heart failure patientsUnplanned return visits-1.6 · 990 casesNoneJul 2022 – Jun 2025
Hospital return days for pneumonia patientsUnplanned return visits20.8 · 976 casesNoneJul 2022 – Jun 2025
Pneumonia (PN) 30-Day Readmission RateUnplanned return visits16.5 · 959 casesNoneJul 2023 – Jun 2025
Rate of emergency department (ED) visits for patients receiving outpatient chemotherapyUnplanned return visits5.2 (4.4 to 6.2) · 2,191 casesNo differentJan 2024 – Dec 2024
Rate of readmission after hip/knee replacementUnplanned return visits5.1 · 425 casesNoneJul 2023 – Jun 2025
Rate of readmission for CABGUnplanned return visits9.6 · 158 casesNoneJul 2023 – Jun 2025
Rate of readmission for chronic obstructive pulmonary disease (COPD) patientsUnplanned return visits19.6 · 183 casesNoneJul 2023 – Jun 2025
Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)Unplanned return visits12.7 (10.4 to 15.4) · 4,578 casesNo differentJan 2022 – Dec 2024

What patients said (6,810 patients answered, 25% of those asked)

Patient survey stars by topic at Stanford Health Care
Cleanliness4
Nurse communication4
Doctor communication4
Communication about medicines3
Discharge information4
Overall hospital rating4
Quietness2
Recommend hospital5
Share of patients giving the best answer at Stanford Health Care
Room was "always" clean75%
Nurses "always" communicated well82%
Doctors "always" communicated well81%
Staff "always" explained63%
Yes, staff "did" give patients this information89%
Yes, staff "did" give patients information about help after discharge89%
Doctors "always" explained things so they could understand76%
Doctors "always" listened carefully80%
Doctors "always" treated them with courtesy and respect87%
Patients who gave a rating of "9" or "10" (high)79%
Staff "always" explained new medications76%
Nurses "always" explained things so they could understand77%
Nurses "always" listened carefully79%
Nurses "always" treated them with courtesy and respect88%
"Always" quiet at night53%
"YES", patients would definitely recommend the hospital83%
Staff "always" explained possible side effects50%
Yes, staff "did" give patients information about possible symptoms90%

Original Medicare doctor bills

$6,901

Medicare paid this office $6,901 for 23 people.

This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.

Largest Original Medicare bills
Hospital discharge day management, more than 30 minutes14$1,469$105

Who their Medicare patients are

23 Original Medicare patients in 2024. Average age 76 · Health risk score 2.90. Above the middle of the specialty; the typical internal medicine clinician is at 1.76.

Conditions among them: High blood pressure 75%.

The office billed $29,653, Medicare allowed $8,835 and paid $6,901; for 66 services of 5 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

Original Medicare by year
20242366762.90$29,653$6,901
20232476793.12$33,187$8,505
20222478801.88$31,577$7,845
20211331693.18$12,233$3,152
20192979663.48$45,322$7,839
201837115723.36$60,081$10,473
201743143693.78$76,141$14,674
20161545715.22$24,396$4,638
201584274693.47$138,891$27,093
201456151752.43$73,918$14,638
201340160743.42$85,456$17,267

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: 3 services

Original Medicare services billed in 2023
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes13$3,949$110
Initial hospital care with moderate level of medical decision making at least 75 minutes12$1,874$156
Hospital discharge day management, more than 30 minutes16$1,714$107

2022: 2 services

Original Medicare services billed in 2022
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes14$3,157$93
Initial hospital care with moderate level of medical decision making at least 75 minutes12$2,155$180

2019: 1 service

Original Medicare services billed in 2019
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes17$3,636$93

2018: 3 services

Original Medicare services billed in 2018
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes22$4,817$93
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes14$2,005$65
Hospital discharge day management, more than 30 minutes12$1,171$98

2017: 3 services

Original Medicare services billed in 2017
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes26$8,208$93
Initial hospital care with moderate level of medical decision making at least 75 minutes16$2,894$181
Hospital discharge day management, 30 minutes or less15$992$66

2015: 3 services

Original Medicare services billed in 2015
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes55$16,660$94
Initial hospital care with moderate level of medical decision making at least 75 minutes24$4,367$182
Hospital discharge day management, 30 minutes or less31$2,073$67

2014: 5 services

Original Medicare services billed in 2014
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes23$5,291$93
Initial hospital care with moderate level of medical decision making at least 75 minutes19$3,433$181
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes15$1,865$64
Hospital discharge day management, more than 30 minutes14$1,360$97
Hospital discharge day management, 30 minutes or less15$988$66

2013: 4 services

Original Medicare services billed in 2013
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes17$5,960$88
Initial hospital care with moderate level of medical decision making at least 75 minutes22$3,820$174
Hospital discharge day management, more than 30 minutes21$1,967$94
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes11$1,128$63

Drugs they prescribed that Part D paid

$6,693

Pharmacies billed $6,693 in 2024.

This is pharmacy cost, not the office bill, and not what patients paid.

25 generic and fewer than 11 brand-name prescriptions · $6,693 in drug cost.

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.

Year by year

Part D prescribing by year
202431NoneNoneNone$6,693
202318None0% (0)None$3,517
202213None0% (0)None$1,218
202112None0% (0)None$2,554
201938NoneNoneNone$3,784
20185216NoneNone$4,611
20173715NoneNone$1,676
201611None0% (0)0%$141
20156731NoneNone$10,168
20146128None18%$15,608
20136019NoneNone$10,294

Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.

Professional record

NPI
1447213160
Licence
CA A69329California A69329: Current · expires 2028-12-31
Trained
Rush Medical College of Rush University, 1998 · 28 years ago
Gender
Male
More record details
Sole proprietor
No
Medicaid ID
CA 00A693290
Taxonomy
Internal medicine (207R00000X); Hospitalist (208M00000X)
Mailing address
300 Pasteur Dr, Stanford, CA, 94305
NPI first listed
2006-04-11
NPI last updated
2024-04-23
NPI record certified
2024-04-23

This is when the NPI record was last certified, not a medical board exam.

Extra NPI addresses: 505 Parnassus Ave, San Francisco, CA, 94143