SONALI P. BIREWAR MD
NPI 1043310352
Internal Medicine - Nephrology in Austin, TX

Active since September 25, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
12221 N MO PAC EXPY, AUSTIN, TX 78758(512) 901-4010(512) 901-3910 Get Directions Write a Review

NPPES record last updated: January 7, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Sonali P. Birewar Md NPPES

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

SONALI P. BIREWAR MD (NPI 1043310352) is an individual nephrology provider in Austin, Texas, licensed in Texas (M5057) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, is affiliated with St David's Medical Center, and is a graduate of Other (1997).

NPPES Registry Identity

NPI1043310352
Entity TypeIndividualFemale
Primary Taxonomy207RN0300X
Provider Legal NameSONALI P. BIREWARCredential: MD
Location Address12221 N MO PAC EXPYAustin, TX 78758-2401
Mailing Address12221 N Mo Pac ExpyAustin, TX 78758-2401 · (512) 901-4010 · Fax (512) 901-3910
Fax(512) 901-3910
Sole ProprietorNo
Medical School CMSOtherGraduated 1997
Enumeration DateSeptember 25, 2006
Last NPPES UpdateJanuary 7, 2022
NPI 1043310352 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License Licensed in TX · M5057
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
12221 N MO PAC EXPY, Austin, TX 78758

Other Identifiers 1

Medicaid184778201TX

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

Sonali P. Birewar 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 ID345342440
PECOS Enrollment IDI20070220000528
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 25

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
230 services83 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
187 services32 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.
172 services113 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
107 services60 patients
Home dialysis services per month (20 years or older) 90966
Home dialysis services provide kidney treatment for patients aged 20 or older right in their own homes. This service includes necessary equipment, supplies, and support for performing dialysis. It's a convenient option that allows patients to maintain their daily routines while receiving essential care.
82 services16 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
79 services48 patients

Hospital Affiliations CMS Care Compare 3

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

St David's Medical Center

Acute Care Hospitals · Austin, TX
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450431
Location919 E 32nd StAustin, TX 78705 · Travis County
Emergency services Birthing friendly

Round Rock Medical Center

Acute Care Hospitals · Round Rock, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number450718
Location2400 Round Rock AveRound Rock, TX 78681 · Williamson County
Emergency services Birthing friendly

North Austin Medical Center

Acute Care Hospitals · Austin, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number450809
Location12221 Mopac Expressway NorthAustin, TX 78758 · Travis County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78758 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
$131.95 typical visit price
range $57.88 – $174.00
Typical copayment $32.98 (range $14.47 – $43.50)
Most-billed visit code 99204
Established Patient
$101.65 typical visit price
range $18.88 – $142.23
Typical copayment $25.41 (range $4.72 – $35.55)
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
85%485 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
74%38 patients3/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
99%174 patients5/55-star benchmark: 99%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
61%174 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
10%174 patients1/55-star benchmark: 59%
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 8

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

Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg J7503
Treatment-Chemotherapy · category RH002N
1 supplier13 claims1,560 services$1.12 avg. paid by Medicare
Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
7 suppliers66 claims9,210 services$0.31 avg. paid by Medicare
Prednisone, immediate release or delayed release, oral, 1 mg J7512
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers25 claims5,400 services$0.01 avg. paid by Medicare
Cyclosporine, oral, 25 mg J7515
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers22 claims3,240 services$0.55 avg. paid by Medicare
Mycophenolate mofetil, oral, 250 mg J7517
Treatment-Treatment - Miscellaneous · category RX029N
4 suppliers40 claims4,650 services$0.20 avg. paid by Medicare
Mycophenolic acid, oral, 180 mg J7518
Treatment-Treatment - Miscellaneous · category RX029N
5 suppliers42 claims5,220 services$0.97 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.

Internal Medicine (Rheumatology)
12221 N MO PAC EXPY, DEPT OF RHEUMATOLOGY
AUSTIN, TX 78758
Obstetrics & Gynecology (Gynecology)
12221 N MO PAC EXPY
AUSTIN, TX 78758
Internal Medicine (Nephrology)
12221 N MO PAC EXPY
AUSTIN, TX 78758
Clinic/Center (Ambulatory Surgical)
12221 N MO PAC EXPY
AUSTIN, TX 78758
Internal Medicine
12221 N MO PAC EXPY, DEPT OF INTERNAL MEDICINE
AUSTIN, TX 78758
Urology
12221 N MO PAC EXPY
AUSTIN, TX 78758
Internal Medicine (Hematology & Oncology)
12221 N MO PAC EXPY
AUSTIN, TX 78758
Internal Medicine (Hematology & Oncology)
12221 N MO PAC EXPY
AUSTIN, TX 78758

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 Sonali Birewar's NPI number?

The NPI number for Sonali Birewar is 1043310352. It was assigned to this individual provider in the NPPES registry on September 25, 2006.

Where is Sonali Birewar located?

Sonali Birewar practices at 12221 N Mo Pac Expy, Austin, TX 78758. The listed phone number is (512) 901-4010.

What is Sonali Birewar's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Sonali Birewar enrolled in Medicare?

Yes. Sonali Birewar 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 Sonali Birewar accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 6 other insurers list Sonali Birewar 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 Sonali Birewar affiliated with any hospitals?

According to CMS data, Sonali Birewar is affiliated with St David's Medical Center, Round Rock Medical Center and North Austin Medical Center.

When was this NPI record last updated?

The NPPES record for Sonali Birewar was last updated on January 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.