SUNIL N MATIWALA M.D.
NPI 1174555601
Internal Medicine in Bloomingdale, IL
Active since July 07, 2006PECOS EnrolledAccepts Medicare Assignment
87.14/100
CMS Quality Rating
303 E ARMY TRAIL RD, SUITE 301, BLOOMINGDALE, IL 60108(630) 893-0347(630) 893-1467 Get Directions Write a Review
About Sunil N Matiwala M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SUNIL N MATIWALA M.D. (NPI 1174555601) is an individual internal medicine provider in Bloomingdale, Illinois, licensed in Illinois (036118604) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Elmhurst Memorial Hospital, and is a graduate of Other (1994).
NPPES Registry Identity
NPI1174555601
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameSUNIL N MATIWALACredential: M.D.
Location Address303 E ARMY TRAIL RD, SUITE 301Bloomingdale, IL 60108-2169
Mailing AddressPo Box 6365Bloomingdale, IL 60108-6365 · (630) 893-0347 · Fax (630) 893-1467
Phone(630) 893-0347
Fax(630) 893-1467
Sole ProprietorNo
Medical School CMSOtherGraduated 1994
Enumeration DateJuly 7, 2006
Last NPPES UpdateMarch 25, 2015
✔ NPI 1174555601 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 036118604
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.
303 E ARMY TRAIL RD, Bloomingdale, IL 60108
Other Identifiers 2
Medicare UPIN208828IL
Medicare UPIN201424IL
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
Sunil N Matiwala 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 ID446355457
PECOS Enrollment IDI20070730000016
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 16
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 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.
513 services108 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.
165 services125 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.
157 services73 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
151 services91 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
150 services114 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
147 services119 patients
Hospital Affiliations CMS Care Compare 5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Elmhurst Memorial Hospital
Acute Care Hospitals · Elmhurst, ILOwnershipProprietary
CMS Certification Number140200
Location155 East Brush Hill RoadElmhurst, IL 60126 · Du Page County
Emergency services Birthing friendly
Northwestern Medicine Delnor Community Hospital
Acute Care Hospitals · Geneva, ILOwnershipVoluntary non-profit - Private
CMS Certification Number140211
Location300 Randall RdGeneva, IL 60134 · Kane County
Emergency services Birthing friendly
Northwestern Medicine Central Dupage Hospital
Acute Care Hospitals · Winfield, ILOwnershipVoluntary non-profit - Private
CMS Certification Number140242
Location25 North Winfield RoadWinfield, IL 60190 · Du Page County
Emergency services Birthing friendly
Alexian Brothers Medical Center 1
Acute Care Hospitals · Elk Grove Village, ILOwnershipVoluntary non-profit - Private
CMS Certification Number140258
Location800 Biesterfield RdElk Grove Village, IL 60007 · Cook County
Emergency services Birthing friendly
Uchicago Medicine Adventhealth Glenoaks
Acute Care Hospitals · Glendale Heights, ILOwnershipVoluntary non-profit - Other
CMS Certification Number140292
Location701 Winthrop AvenueGlendale Heights, IL 60139 · Du Page County
Emergency services Birthing friendly
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 60108 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
$137.43 typical visit price
range $59.81 – $181.38
Typical copayment $34.35 (range $14.95 – $45.34)
Most-billed visit code 99204
Established Patient
$105.07 typical visit price
range $19.15 – $147.12
Typical copayment $26.26 (range $4.78 – $36.78)
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.
87.14/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practiceQuality
81.74
Promoting Interoperability
74
Improvement Activities
40
Reported Quality Measures
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
43%122 patients2/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
41%264 patients2/55-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
35%107 patients2/55-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%1,685 patients5/55-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.
75%1,097 patients1/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
56%215 patients3/55-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…
25%155 patients2/55-star benchmark: 88%
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.
24%283 patients2/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
64%162 patients3/55-star benchmark: 90%
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…
90%464 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
58%280 patients3/55-star benchmark: 88%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
91%394 patients4/55-star benchmark: 96%
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…
76%283 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…
56%283 patients3/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 1% · 162 patients
6%162 patients3/55-star benchmark: 100%
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.
18%283 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 7
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
15 suppliers42 claims133 services$6.39 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
10 suppliers23 claims44 services$1.10 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
2 suppliers14 claims4,997 services$0.03 avg. paid by Medicare
Lightweight wheelchair K0003
DME-Wheelchairs · category DD000N
1 supplier21 claims21 services$32.26 avg. paid by Medicare
Elevating leg rests, pair (for use with capped rental wheelchair base) K0195
DME-Wheelchairs · category DD021N
1 supplier21 claims21 services$8.86 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
2 suppliers19 claims19 services$195.04 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.
Counselor (Professional)
303 E ARMY TRAIL RD, SUITE 207
BLOOMINGDALE, IL 60108
BLOOMINGDALE, IL 60108
Podiatrist (Foot & Ankle Surgery)
303 E ARMY TRAIL RD, SUITE #101
BLOOMINGDALE, IL 60108
BLOOMINGDALE, IL 60108
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 Sunil Matiwala's NPI number?
The NPI number for Sunil Matiwala is 1174555601. It was assigned to this individual provider in the NPPES registry on July 7, 2006.
Where is Sunil Matiwala located?
Sunil Matiwala practices at 303 E Army Trail Rd Suite 301, Bloomingdale, IL 60108. The listed phone number is (630) 893-0347.
What is Sunil Matiwala's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Sunil Matiwala enrolled in Medicare?
Yes. Sunil Matiwala 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.
Is Sunil Matiwala affiliated with any hospitals?
According to CMS data, Sunil Matiwala is affiliated with Elmhurst Memorial Hospital, Northwestern Medicine Delnor Community Hospital, Northwestern Medicine Central Dupage Hospital, Alexian Brothers Medical Center 1 and Uchicago Medicine Adventhealth Glenoaks.
When was this NPI record last updated?
The NPPES record for Sunil Matiwala was last updated on March 25, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Sunil N Matiwala, M.D. · NPI 1174555601
Internal Medicine physician in Bloomingdale, Illinois. Individual provider, active in the CMS NPPES registry since July 7, 2006.
## Identity
- **NPI:** 1174555601 (Entity type: Individual)
- **Enumerated:** July 7, 2006
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** 036118604 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 303 E ARMY TRAIL RD, SUITE 301, Bloomingdale, IL 60108-2169
- **Phone:** (630) 893-0347 · **Fax:** (630) 893-1467
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 1994
## Record status
- **NPPES last updated:** March 25, 2015
- **Other identifiers:** Medicare UPIN 208828 (IL); Medicare UPIN 201424 (IL)
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Source: [NPI Profile](https://npiprofile.com/npi/1174555601) · Data from the CMS NPPES public registry.