GURMINDER DHILLON MD
NPI 1013263854
Internal Medicine - Pulmonary Disease in Sheboygan, WI

Active since July 31, 2012PECOS EnrolledAccepts Medicare Assignment
94.61/100
CMS Quality Rating
3100 SUPERIOR AVE, SHEBOYGAN, WI 53081(920) 496-4700(816) 404-0003 Get Directions Write a Review

NPPES record last updated: January 25, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Gurminder Dhillon Md NPPES

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

GURMINDER DHILLON MD (NPI 1013263854) is an individual pulmonary disease provider in Sheboygan, Wisconsin, licensed in Wisconsin (64235-20) and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS, is affiliated with Valley Medical Center, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1013263854
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameGURMINDER DHILLONCredential: MD
Location Address3100 SUPERIOR AVESheboygan, WI 53081-1948
Mailing AddressPo Box 19070Green Bay, WI 54307-9070 · (920) 496-4700
Fax(816) 404-0003
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateJuly 31, 2012
Last NPPES UpdateJanuary 25, 2024
NPPES CertifiedJanuary 25, 2024
NPI 1013263854 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License Licensed in WI · 64235-20
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
3100 SUPERIOR AVE, Sheboygan, WI 53081

Other Identifiers 1

Medicaid100046016WI

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

Gurminder Dhillon Md 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 ID8325371776
PECOS Enrollment IDI20241021002726
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 12

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.

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.
192 services155 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.
64 services64 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
63 services62 patients
Test to measure expiratory airflow and volume changes before and after medication administration 94060
This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.
60 services60 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
57 services25 patients
Test to determine lung volumes using sensors 94726
This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.
55 services55 patients

Hospital Affiliations CMS Care Compare

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

Valley Medical Center

Acute Care Hospitals · Renton, WA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number500088
Location400 S 43rd StRenton, WA 98055 · King County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53081 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 24

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
9 suppliers207 claims207 services$35.92 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable A7005
DME-Other DME · category DE000N
3 suppliers12 claims13 services$15.84 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
8 suppliers177 claims177 services$89.80 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
8 suppliers176 claims454 services$33.52 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
6 suppliers40 claims209 services$18.12 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
5 suppliers35 claims171 services$14.65 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 20

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

Anesthesiology
3100 SUPERIOR AVE
SHEBOYGAN, WI 53081
Hospitalist
3100 SUPERIOR AVE
SHEBOYGAN, WI 53081
Internal Medicine
3100 SUPERIOR AVE
SHEBOYGAN, WI 53081
Family Medicine
3100 SUPERIOR AVE
SHEBOYGAN, WI 53081
Radiology (Vascular & Interventional Radiology)
3100 SUPERIOR AVE
SHEBOYGAN, WI 53081
Nurse Practitioner (Family)
3100 SUPERIOR AVE
SHEBOYGAN, WI 53081
Anesthesiology
3100 SUPERIOR AVE
SHEBOYGAN, WI 53081
Clinical Medical Laboratory
3100 SUPERIOR AVE
SHEBOYGAN, WI 53081

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 Gurminder Dhillon's NPI number?

The NPI number for Gurminder Dhillon is 1013263854. It was assigned to this individual provider in the NPPES registry on July 31, 2012.

Where is Gurminder Dhillon located?

Gurminder Dhillon practices at 3100 Superior Ave, Sheboygan, WI 53081. The listed phone number is (920) 496-4700.

What is Gurminder Dhillon's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Gurminder Dhillon enrolled in Medicare?

Yes. Gurminder Dhillon 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 Gurminder Dhillon accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Gurminder Dhillon 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 Gurminder Dhillon affiliated with any hospitals?

According to CMS data, Gurminder Dhillon is affiliated with Valley Medical Center.

When was this NPI record last updated?

The NPPES record for Gurminder Dhillon was last updated on January 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.