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HEMANT KUMAR SINHA MD
NPI 1093823288
Internal Medicine in Ashville, AL

Active since August 28, 2006PECOS EnrolledAccepts Medicare Assignment
74.21/100
CMS Quality Rating
35772 US HIGHWAY 231, ASHVILLE, AL 35953(205) 594-5950(205) 594-5742 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Hemant Kumar Sinha Md NPPES

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

HEMANT KUMAR SINHA MD (NPI 1093823288) is an individual internal medicine provider in Ashville, Alabama, licensed in Alabama (22164) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1983).

NPPES Registry Identity

NPI1093823288
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameHEMANT KUMAR SINHACredential: MD
Location Address35772 US HIGHWAY 231Ashville, AL 35953-3039
Mailing Address112 Merit CirGadsden, AL 35901-5726 · (256) 546-1640
Phone(205) 594-5950
Fax(205) 594-5742
Sole ProprietorYes
Medical School CMSOtherGraduated 1983
Enumeration DateAugust 28, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1093823288 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in AL · 22164
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.
35772 US HIGHWAY 231, Ashville, AL 35953
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Other Identifiers 1

Medicare UPING96105AL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Hemant Kumar Sinha 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 ID9830140920
PECOS Enrollment IDI20050207000257
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.

Medicare Billing Reassignment

Medicare enrollment records show Hemant Sinha reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Hemant Sinha PC
21 mi
Specialist
GADSDEN REGIONAL MEDICAL CENTER, 1107 GOODYEAR AVE.
Gadsden, AL 35903
  • Reassigned Medicare billing, Alabama enrollment
NPI 1649485582 (256) 546-1190

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

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.
2,477 services490 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
477 services399 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
463 services380 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.
306 services120 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
219 services28 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
185 services167 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35953 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
$122.31 typical visit price
range $52.65 – $161.63
Typical copayment $30.57 (range $13.16 – $40.40)
Most-billed visit code 99204
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
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.

74.21/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality48.21
Improvement Activities40
Cost52.65

Reported Quality Measures

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…
100%1,609 patients5/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%3,076 patients5/55-star benchmark: 100%
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.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
4 suppliers88 claims88 services$17.10 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers22 claims22 services$6.42 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
5 suppliers105 claims105 services$87.96 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
3 suppliers16 claims16 services$34.08 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
2 suppliers13 claims13 services$17.94 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Hemant Sinha's NPI number?

The NPI number for Hemant Sinha is 1093823288. It was assigned to this individual provider in the NPPES registry on August 28, 2006.

Where is Hemant Sinha located?

Hemant Sinha practices at 35772 Us Highway 231, Ashville, AL 35953. The listed phone number is (205) 594-5950.

What is Hemant Sinha's specialty?

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

Is Hemant Sinha enrolled in Medicare?

Yes. Hemant Sinha 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.

Which organization bills Medicare for Hemant Sinha's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Hemant Sinha reassigns Medicare benefits to Hemant Sinha PC (Gadsden, AL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Hemant Sinha's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Hemant Sinha accept?

Health plans from Blue Cross and Blue Shield of Alabama list Hemant Sinha 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.

When was this NPI record last updated?

The NPPES record for Hemant Sinha was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.