DR. NANTHINI SUTHAN M.D
NPI 1053504506
Internal Medicine in Highland, IL

Active since August 18, 2007PECOS EnrolledAccepts Medicare Assignment
12860 TROXLER AVE, HIGHLAND, IL 62249(618) 651-2810 Get Directions Write a Review

NPPES record last updated: February 7, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Nanthini Suthan M.d NPPES

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

DR. NANTHINI SUTHAN M.D (NPI 1053504506) is an individual internal medicine provider in Highland, Illinois, licensed in Illinois (036126643) and active in the NPI registry since August 2007. She is enrolled in Medicare PECOS, is affiliated with Alton Memorial Hospital, and maintains a secondary practice location in East Alton.

NPPES Registry Identity

NPI1053504506
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. NANTHINI SUTHANCredential: M.D
Location Address12860 TROXLER AVEHighland, IL 62249-2898
Mailing Address12860 Troxler AveHighland, IL 62249-2898
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateAugust 18, 2007
Last NPPES UpdateFebruary 7, 2025
NPPES CertifiedFebruary 7, 2025
NPI 1053504506 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses Licensed in IL · 036126643 Licensed in GA · 059772
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

12860 TROXLER AVE, Highland, IL 62249

Secondary Practice Location 1

Location 12 Terminal Dr, Suite 8East Alton, IL 62024-2201 · Phone (618) 258-0485 · Fax (618) 258-4815

Other Identifiers 1

Other448758879AGA · Peachcare For Kids

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

Dr. Nanthini Suthan 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 ID7719073816
PECOS Enrollment IDI20071022000149, I20110223000798
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.

Hospital Affiliations CMS Care Compare 5

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

Alton Memorial Hospital

Acute Care Hospitals · Alton, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140002
LocationOne Memorial DriveAlton, IL 62002 · Madison County
Emergency services Birthing friendly

Hshs Holy Family Hospital Inc

Acute Care Hospitals · Greenville, IL
OwnershipVoluntary non-profit - Church
CMS Certification Number140137
Location200 Health Care DrGreenville, IL 62246 · Bond County
Emergency services

St Josephs Hospital

Acute Care Hospitals · Breese, IL
OwnershipVoluntary non-profit - Church
CMS Certification Number140145
Location9515 Holy Cross LnBreese, IL 62230 · Clinton County
Emergency services Birthing friendly

Hshs St Elizabeth's Hospital

Acute Care Hospitals · O Fallon, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140187
LocationOne St Elizabeth BoulevardO Fallon, IL 62269 · St. Clair County
Emergency services Birthing friendly

St Joseph's Hospital

Critical Access Hospitals · Highland, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number141336
Location12866 Troxler AvenueHighland, IL 62249 · Madison County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62249 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
$131.14 typical visit price
range $56.28 – $173.35
Typical copayment $32.78 (range $14.07 – $43.33)
Most-billed visit code 99204
Established Patient
$99.71 typical visit price
range $17.51 – $139.99
Typical copayment $24.92 (range $4.37 – $34.99)
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.

Reported Quality Measures

Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse)
Percentage of patients, aged 18 years and older, with a diagnosis of acute viral sinusitis who were prescribed an antibiotic within 10 days after onset of symptoms
Lower rates are better for this measure.
95%65 patients1/55-star benchmark: 100%
Adult Sinusitis: Computerized Tomography (CT) for Acute Sinusitis (Overuse)
Percentage of patients aged 18 years and older with a diagnosis of acute sinusitis who had a computerized tomography (CT) scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis
Lower rates are better for this measure.
0%62 patients
Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
8%125 patients1/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
77%395 patients4/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
6%185 patients1/55-star benchmark: 100%
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.
98%9,828 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
52%582 patients3/55-star benchmark: 88%
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.
100%552 patients5/55-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.
84%925 patients4/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
92%907 patients4/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
51%866 patients3/55-star benchmark: 88%
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…
99%925 patients4/55-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…
18%925 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
23%925 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 3

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers25 claims29 services$14.10 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers25 claims29 services$62.62 avg. paid by Medicare
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620
DME-Drugs Administered Through DME · category DG006N
2 suppliers13 claims1,338 services$0.09 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.

Chiropractor
12860 TROXLER AVE
HIGHLAND, IL 62249
Nurse Practitioner
12860 TROXLER AVE
HIGHLAND, IL 62249
Physician Assistant
12860 TROXLER AVE
HIGHLAND, IL 62249
Family Medicine
12860 TROXLER AVE
HIGHLAND, IL 62249
Nurse Practitioner
12860 TROXLER AVE
HIGHLAND, IL 62249
Nurse Practitioner
12860 TROXLER AVE
HIGHLAND, IL 62249
Family Medicine
12860 TROXLER AVE
HIGHLAND, IL 62249
Internal Medicine
12860 TROXLER AVE
HIGHLAND, IL 62249

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 Nanthini Suthan's NPI number?

The NPI number for Nanthini Suthan is 1053504506. It was assigned to this individual provider in the NPPES registry on August 18, 2007.

Where is Nanthini Suthan located?

Nanthini Suthan practices at 12860 Troxler Ave, Highland, IL 62249. The listed phone number is (618) 651-2810.

What is Nanthini Suthan's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Nanthini Suthan enrolled in Medicare?

Yes. Nanthini Suthan 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 Nanthini Suthan accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Nanthini Suthan 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 Nanthini Suthan affiliated with any hospitals?

According to CMS data, Nanthini Suthan is affiliated with Alton Memorial Hospital, Hshs Holy Family Hospital Inc, St Josephs Hospital, Hshs St Elizabeth's Hospital and St Joseph's Hospital.

When was this NPI record last updated?

The NPPES record for Nanthini Suthan was last updated on February 7, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.