SUNIL K DWIVEDI M.D.
NPI 1003854076
Internal Medicine - Gastroenterology in San Antonio, TX

Active since June 03, 2006PECOS EnrolledAccepts Medicare Assignment
79.87/100
CMS Quality Rating
5223 HAMILTON WOLFE RD, SAN ANTONIO, TX 78229(210) 614-1234(210) 614-0952 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 17, 2018, Feb 15, 2018 (2 updates tracked since 2018).

About Sunil K Dwivedi M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUNIL K DWIVEDI M.D. (NPI 1003854076) is an individual gastroenterology provider in San Antonio, Texas, licensed in Texas (M3528) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Methodist Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1003854076
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameSUNIL K DWIVEDICredential: M.D.
Location Address5223 HAMILTON WOLFE RDSan Antonio, TX 78229-4463
Mailing Address8415 Datapoint Dr Ste 700San Antonio, TX 78229-3327 · (210) 614-1234 · Fax (210) 614-0952
Fax(210) 614-0952
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateJune 3, 2006
Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration
NPI 1003854076 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License Licensed in TX · M3528
Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

5223 HAMILTON WOLFE RD, San Antonio, TX 78229

Secondary Practice Locations 2

Location 1855 Proton RdSan Antonio, TX 78258-4203 · Phone (210) 614-1234 · Fax (210) 614-0952
Location 212850 Toepperwein RdLive Oak, TX 78233-4115 · Phone (210) 614-1234 · Fax (210) 614-0952

Other Identifiers 3

Medicaid174532504TX
Other8CJ470Blue Cross Blue Shield Of Texas
OtherTXB105184TX · Medicare

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Sunil K Dwivedi M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2062440605
PECOS Enrollment IDI20050803000900
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
106 services104 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
100 services100 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
96 services96 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
69 services58 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
38 services38 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
37 services37 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Methodist Hospital

Acute Care Hospitals · San Antonio, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number450388
Location7700 Floyd Curl DrSan Antonio, TX 78229 · Bexar County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78229 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

79.87/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality68.55
Promoting Interoperability100
Improvement Activities40
Cost64.36

Reported Quality Measures

Photodocumentation of Cecal Intubation
The rate of screening and surveillance colonoscopies for which photodocumentation of landmarks of cecal intubation is performed to establish a complete examination
100%166 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034
Other-Enteral and Parenteral · category OB006N
1 supplier11 claims330 services$2.38 avg. paid by Medicare
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
1 supplier11 claims341 services$7.66 avg. paid by Medicare
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4150
Other-Enteral and Parenteral · category OB006N
1 supplier11 claims5,082 services$0.45 avg. paid by Medicare
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152
Other-Enteral and Parenteral · category OB006N
1 supplier12 claims5,288 services$0.24 avg. paid by Medicare
Iv pole E0776
DME-Other DME · category DE000N
1 supplier12 claims12 services$12.70 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine (Gastroenterology)
5223 HAMILTON WOLFE RD
SAN ANTONIO, TX 78229
Internal Medicine (Gastroenterology)
5223 HAMILTON WOLFE RD
SAN ANTONIO, TX 78229
Internal Medicine (Gastroenterology)
5223 HAMILTON WOLFE RD
SAN ANTONIO, TX 78229
Internal Medicine (Gastroenterology)
5223 HAMILTON WOLFE RD
SAN ANTONIO, TX 78229
Internal Medicine (Gastroenterology)
5223 HAMILTON WOLFE RD
SAN ANTONIO, TX 78229
Internal Medicine (Gastroenterology)
5223 HAMILTON WOLFE RD
SAN ANTONIO, TX 78229
Internal Medicine (Gastroenterology)
5223 HAMILTON WOLFE RD
SAN ANTONIO, TX 78229
Anesthesiology
5223 HAMILTON WOLFE RD
SAN ANTONIO, TX 78229

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sunil Dwivedi's NPI number?

The NPI number for Sunil Dwivedi is 1003854076. It was assigned to this individual provider in the NPPES registry on June 3, 2006.

Where is Sunil Dwivedi located?

Sunil Dwivedi practices at 5223 Hamilton Wolfe Rd, San Antonio, TX 78229. The listed phone number is (210) 614-1234.

What is Sunil Dwivedi's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Sunil Dwivedi enrolled in Medicare?

Yes. Sunil Dwivedi is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Sunil Dwivedi accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 5 other insurers list Sunil Dwivedi as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Sunil Dwivedi affiliated with any hospitals?

According to CMS data, Sunil Dwivedi is affiliated with Methodist Hospital.

When was this NPI record last updated?

The NPPES record for Sunil Dwivedi was last updated on March 17, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.