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DR. SUNIL NAGPAL M.D.
NPI 1194734640
Internal Medicine - Hematology & Oncology in Kalamazoo, MI

Active since August 05, 2006PECOS EnrolledAccepts Medicare Assignment
84.88/100
CMS Quality Rating
805 JOHN STREET, KALAMAZOO, MI 49007(269) 286-7170 Get Directions Write a Review

NPPES record last updated: February 2, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 2, 2021, Oct 9, 2020 (2 updates tracked since 2020).

About Dr. Sunil Nagpal M.d. NPPES

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

DR. SUNIL NAGPAL M.D. (NPI 1194734640) is an individual hematology & oncology provider in Kalamazoo, Michigan, licensed in Michigan (4301062595) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Bronson Methodist Hospital, and maintains a secondary practice location in Kalamazoo.

NPPES Registry Identity

NPI1194734640
Entity TypeIndividualMale
Primary Taxonomy207RH0003X
Provider Legal NameDR. SUNIL NAGPALCredential: M.D.
Location Address805 JOHN STREETKalamazoo, MI 49007
Mailing Address805 John StreetKalamazoo, MI 49007
Phone(269) 286-7170
Sole ProprietorNo
Medical School CMSOtherGraduated 1989
Enumeration DateAugust 5, 2006
Last NPPES UpdateFebruary 2, 20212 updates tracked since enumeration
NPPES CertifiedJanuary 15, 2021
✔ NPI 1194734640 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
License✔ Licensed in MI · 4301062595
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
805 JOHN STREET, Kalamazoo, MI 49007
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Secondary Practice Location 1

Location 1200 N Park StKalamazoo, MI 49007-3731 · Phone (269) 382-2500 · Fax (269) 373-7478

Other Identifiers 5

Other0007732088MI · Aetna
Other0985118MI · Health Plus
Other110B564040MI · Bcr
Other110B564040MI · Bcn
Medicaid4112810MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.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. Sunil Nagpal 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 ID7517964257
PECOS Enrollment IDI20061023000281
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 7

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.

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.
447 services247 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
172 services142 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.
103 services59 patients
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.
54 services24 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
26 services26 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.
18 services14 patients

Hospital Affiliations CMS Care Compare 5

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

Bronson Methodist Hospital

Acute Care Hospitals · Kalamazoo, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230017
Location601 John StreetKalamazoo, MI 49007 · Kalamazoo County
Emergency services Birthing friendly

Bronson Battle Creek Hospital

Acute Care Hospitals · Battle Creek, MI
4/5 CMS rating
OwnershipProprietary
CMS Certification Number230075
Location300 North AvenueBattle Creek, MI 49017 · Calhoun County
Emergency services Birthing friendly

Bronson South Haven Hospital

Acute Care Hospitals · South Haven, MI
OwnershipGovernment - Hospital District or Authority
CMS Certification Number230085
Location955 S Bailey AveSouth Haven, MI 49090 · Van Buren County
Emergency services

Borgess Medical Center

Acute Care Hospitals · Kalamazoo, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number230117
Location1521 Gull RoadKalamazoo, MI 49048 · Kalamazoo County
Emergency services Birthing friendly

Bronson Lakeview Hospital

Critical Access Hospitals · Paw Paw, MI
OwnershipVoluntary non-profit - Private
CMS Certification Number231332
Location408 Hazen StreetPaw Paw, MI 49079 · Van Buren County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49007 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
$166.68 typical visit price
range $54.34 – $166.68
Typical copayment $41.67 (range $13.58 – $41.67)
Most-billed visit code 99205
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

84.88/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.29
Promoting Interoperability100
Improvement Activities40
Cost68.32

Referred Medical Equipment & Supplies CMS DME claims 2

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

Capecitabine, oral, 500 mg J8521
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers12 claims868 services$0.64 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
2 suppliers16 claims16 services$17.69 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 Sunil Nagpal's NPI number?

The NPI number for Sunil Nagpal is 1194734640. It was assigned to this individual provider in the NPPES registry on August 5, 2006.

Where is Sunil Nagpal located?

Sunil Nagpal practices at 805 John Street, Kalamazoo, MI 49007. The listed phone number is (269) 286-7170.

What is Sunil Nagpal's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Is Sunil Nagpal enrolled in Medicare?

Yes. Sunil Nagpal 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 Sunil Nagpal accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list Sunil Nagpal 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 Sunil Nagpal affiliated with any hospitals?

According to CMS data, Sunil Nagpal is affiliated with Bronson Methodist Hospital, Bronson Battle Creek Hospital, Bronson South Haven Hospital, Borgess Medical Center and Bronson Lakeview Hospital.

When was this NPI record last updated?

The NPPES record for Sunil Nagpal was last updated on February 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.