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DR. SACHIN SONI M.D
NPI 1205169380
Internal Medicine in Houston, TX

Active since September 08, 2009PECOS EnrolledAccepts Medicare Assignment
29.33/100
CMS Quality Rating
6431 FANNIN ST, MSB 4.148, HOUSTON, TX 77030(713) 500-6880(713) 500-6882 Get Directions Write a Review

NPPES record last updated: September 8, 2009. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Sachin Soni M.d NPPES

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

DR. SACHIN SONI M.D (NPI 1205169380) is an individual internal medicine provider in Houston, Texas, licensed in Texas (BP1-0026241) and active in the NPI registry since September 2009. He is enrolled in Medicare PECOS, is affiliated with Memorial Hermann Hospital System, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1205169380
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. SACHIN SONICredential: M.D
Location Address6431 FANNIN ST, MSB 4.148Houston, TX 77030-1501
Mailing Address6431 Fannin St, Msb 4.148Houston, TX 77030-1501 · (713) 500-6880 · Fax (713) 500-6882
Phone(713) 500-6880
Fax(713) 500-6882
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateSeptember 8, 2009
✔ NPI 1205169380 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in TX · BP1-0026241
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.
Also ListedInternal Medicine · NephrologyTaxonomy 207RN0300X · License BP2-0035684 (TX)
6431 FANNIN ST, Houston, TX 77030
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.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

Dr. Sachin Soni 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 ID8729252127
PECOS Enrollment IDI20111121000978
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 Reassignments

2

Medicare enrollment records show Sachin Soni reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ritesh A. Mathur M.D., P.A
17 mi
Nephrology
4780 SWEETWATER BLVD, STE 100
Sugar Land, TX 77479
  • Reassigned Medicare billing, Texas enrollment
  • Medicare enrollment name: Ritesh A. Mathur, MD, PA
  • 3 clinicians in this Medicare group
NPI 1417105487 (832) 532-7756
Four Corners Nephrology Associates PC
884 mi
Nephrology
622 W MAPLE ST STE H
Farmington, NM 87401
  • Reassigned Medicare billing, New Mexico enrollment
  • 6 clinicians in this Medicare group
NPI 1144327172 (505) 326-6521

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 9

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.
1,272 services249 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.
286 services115 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.
236 services129 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.
144 services128 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.
64 services58 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.
43 services41 patients

Hospital Affiliations CMS Care Compare 4

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

Memorial Hermann Hospital System

Acute Care Hospitals · Houston, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450184
Location1635 North Loop WestHouston, TX 77008 · Harris County
Emergency services Birthing friendly

Houston Methodist Hospital

Acute Care Hospitals · Houston, TX
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450358
Location6565 FanninHouston, TX 77030 · Harris County
Emergency services Birthing friendly

Houston Methodist Sugarland Hospital

Acute Care Hospitals · Sugar Land, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450820
Location16655 Southwest FreewaySugar Land, TX 77479 · Fort Bend County
Emergency services Birthing friendly

Memorial Hermann Sugar Land Hospital

Acute Care Hospitals · Sugar Land, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450848
Location17500 W Grand Parkway SouthSugar Land, TX 77479 · Fort Bend County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77030 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
$134.06 typical visit price
range $58.24 – $176.98
Typical copayment $33.51 (range $14.56 – $44.24)
Most-billed visit code 99204
Established Patient
$102.71 typical visit price
range $18.60 – $143.93
Typical copayment $25.67 (range $4.65 – $35.98)
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.

29.33/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality15
Improvement Activities0
Cost55.46

Reported Quality Measures

Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
99%88 patients5/55-star benchmark: 99%
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%1,091 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.
99%587 patients4/55-star benchmark: 100%
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%282 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.
100%522 patients5/55-star benchmark: 100%
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…
18%522 patients1/55-star benchmark: 97%
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…
45%522 patients2/55-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…
5%522 patients1/55-star benchmark: 79%
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+: 0% · 294 patients
1%294 patients4/55-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.

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.

DR. STUART MASON FRASER M.D.
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
6431 FANNIN ST, MSB 3.151
HOUSTON, TX 77030
Harris County (713) 500-5800
AMY ROSSI MD
Emergency Medicine
6431 FANNIN ST, JJL 431
HOUSTON, TX 77030
Harris County (713) 500-7882
MATTHEW KHOA NGUYEN
Student in an Organized Health Care Education/Training Program
6431 FANNIN ST
HOUSTON, TX 77030
Harris County (713) 500-6113
MARY WAYNE PELTIER MD
Student in an Organized Health Care Education/Training Program
6431 FANNIN ST
HOUSTON, TX 77030
Harris County (713) 500-5010
HANNA MAVRIC DO
Student in an Organized Health Care Education/Training Program
6431 FANNIN ST
HOUSTON, TX 77030
Harris County (713) 500-7882
DR. DAVIDE CATTANO MD
Anesthesiology
6431 FANNIN ST, MSB 5.020
HOUSTON, TX 77030
Harris County (713) 500-6235
MICHAEL ANTHONY HOLZMAN
Orthopaedic Surgery
6431 FANNIN ST, SUITE JJL 310
HOUSTON, TX 77030
Harris County (713) 500-5154
SHUBHANGI MEHRA
Student in an Organized Health Care Education/Training Program
6431 FANNIN ST
HOUSTON, TX 77030
Harris County (713) 500-0798

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 Sachin Soni's NPI number?

The NPI number for Sachin Soni is 1205169380. It was assigned to this individual provider in the NPPES registry on September 8, 2009.

Where is Sachin Soni located?

Sachin Soni practices at 6431 Fannin St Msb 4.148, Houston, TX 77030. The listed phone number is (713) 500-6880.

What is Sachin Soni's specialty?

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

Is Sachin Soni enrolled in Medicare?

Yes. Sachin Soni 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 organizations bill Medicare for Sachin Soni's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sachin Soni reassigns Medicare benefits to 2 organizations: Ritesh A. Mathur M.D., P.A (Sugar Land, TX) and Four Corners Nephrology Associates PC (Farmington, NM). Each 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 Sachin Soni's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sachin Soni accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 5 other insurers list Sachin Soni 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 Sachin Soni affiliated with any hospitals?

According to CMS data, Sachin Soni is affiliated with Memorial Hermann Hospital System, Houston Methodist Hospital, Houston Methodist Sugarland Hospital and Memorial Hermann Sugar Land Hospital.

When was this NPI record last updated?

The NPPES record for Sachin Soni was last updated on September 8, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.