DR. SUMEET K. TEWANI MD
NPI 1154597284
Internal Medicine - Gastroenterology in Rockford, IL

Active since May 08, 2008PECOS EnrolledAccepts Medicare Assignment
60.25/100
CMS Quality Rating
401 ROXBURY RD, ROCKFORD, IL 61107(815) 397-7340(815) 397-7388 Get Directions Write a Review

NPPES record last updated: February 7, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Sumeet K. Tewani Md NPPES

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

DR. SUMEET K. TEWANI MD (NPI 1154597284) is an individual gastroenterology provider in Rockford, Illinois, licensed in Massachusetts (242616) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS, is affiliated with Cgh Medical Center, and is a graduate of Boston University School Of Medicine (2007).

NPPES Registry Identity

NPI1154597284
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. SUMEET K. TEWANICredential: MD
Location Address401 ROXBURY RDRockford, IL 61107-5075
Mailing Address401 Roxbury RdRockford, IL 61107-5075 · (815) 397-7340 · Fax (815) 397-7388
Fax(815) 397-7388
Sole ProprietorNo
Medical School CMSBoston University School Of MedicineGraduated 2007
Enumeration DateMay 8, 2008
Last NPPES UpdateFebruary 7, 2017
NPI 1154597284 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License Licensed in MA · 242616
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.
Also ListedInternal MedicineTaxonomy 207R00000X · License 242616 (MA)
Also ListedInternal Medicine · HepatologyTaxonomy 207RI0008X · License 242616 (MA)
401 ROXBURY RD, Rockford, IL 61107

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. Sumeet K. Tewani 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 ID1456576016
PECOS Enrollment IDI20140715002598
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 21

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.

Pathology examination of tissue using a microscope, intermediate complexity 88305
A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.
148 services42 patients
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito G0500
Moderate sedation is a method where a physician uses medication to help you relax during a gastrointestinal endoscopy. An independent trained observer will be present to monitor your vital signs and ensure your safety throughout the procedure. It's a common and safe practice.
85 services83 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.
81 services80 patients
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.
63 services62 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.
55 services50 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.
53 services53 patients

Hospital Affiliations CMS Care Compare 4

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

Cgh Medical Center

Acute Care Hospitals · Sterling, IL
2/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number140043
Location100 East Lefevre RoadSterling, IL 61081 · Whiteside County
Emergency services Birthing friendly

Osf Saint Elizabeth Mdl Ctr

Acute Care Hospitals · Ottawa, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140110
Location1100 E Norris DriveOttawa, IL 61350 · La Salle County
Emergency services Birthing friendly

Uw Health

Acute Care Hospitals · Rockford, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140228
Location1401 East State StreetRockford, IL 61104 · Winnebago County
Emergency services Birthing friendly

Saint Anthony Medical Center

Acute Care Hospitals · Rockford, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140233
Location5666 East State StreetRockford, IL 61108 · Winnebago County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61107 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
$127.46 typical visit price
range $54.80 – $168.44
Typical copayment $31.86 (range $13.70 – $42.11)
Most-billed visit code 99204
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

60.25/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality11.05
Promoting Interoperability80
Improvement Activities40
Cost73.13

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 (Gastroenterology)
401 ROXBURY RD
ROCKFORD, IL 61107
Internal Medicine (Gastroenterology)
401 ROXBURY RD
ROCKFORD, IL 61107
Internal Medicine (Gastroenterology)
401 ROXBURY RD
ROCKFORD, IL 61107
Internal Medicine (Gastroenterology)
401 ROXBURY RD
ROCKFORD, IL 61107
Internal Medicine (Gastroenterology)
401 ROXBURY RD
ROCKFORD, IL 61107
Internal Medicine (Gastroenterology)
401 ROXBURY RD
ROCKFORD, IL 61107
Internal Medicine (Gastroenterology)
401 ROXBURY RD
ROCKFORD, IL 61107
Internal Medicine (Gastroenterology)
401 ROXBURY RD
ROCKFORD, IL 61107

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 Sumeet Tewani's NPI number?

The NPI number for Sumeet Tewani is 1154597284. It was assigned to this individual provider in the NPPES registry on May 8, 2008.

Where is Sumeet Tewani located?

Sumeet Tewani practices at 401 Roxbury Rd, Rockford, IL 61107. The listed phone number is (815) 397-7340.

What is Sumeet Tewani's specialty?

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

Is Sumeet Tewani enrolled in Medicare?

Yes. Sumeet Tewani 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 Sumeet Tewani accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health and Quartz list Sumeet Tewani 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 Sumeet Tewani affiliated with any hospitals?

According to CMS data, Sumeet Tewani is affiliated with Cgh Medical Center, Osf Saint Elizabeth Mdl Ctr, Uw Health and Saint Anthony Medical Center.

When was this NPI record last updated?

The NPPES record for Sumeet Tewani was last updated on February 7, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.