SUMIT TIWARI MD
NPI 1215048574
Internal Medicine - Cardiovascular Disease in East Alton, IL

Active since August 31, 2006PECOS EnrolledAccepts Medicare Assignment
2 TERMINAL DR STE 4B, EAST ALTON, IL 62024(618) 216-8127(618) 216-8128 Get Directions Write a Review

NPPES record last updated: May 1, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 12, 2021, Jul 23, 2020, Oct 11, 2016 (3 updates tracked since 2016).

About Sumit Tiwari Md NPPES

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

SUMIT TIWARI MD (NPI 1215048574) is an individual cardiovascular disease provider in East Alton, Illinois, licensed in Illinois (036153016) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Alton Memorial Hospital, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1215048574
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameSUMIT TIWARICredential: MD
Location Address2 TERMINAL DR STE 4BEast Alton, IL 62024-2296
Mailing Address2 Terminal Dr Ste 4bEast Alton, IL 62024-2296 · (618) 216-8127 · Fax (618) 216-8128
Fax(618) 216-8128
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateAugust 31, 2006
Last NPPES UpdateMay 1, 20253 updates tracked since enumeration
NPPES CertifiedMay 1, 2025
NPI 1215048574 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Licenses Licensed in IL · 036153016 Licensed in ND · 12760
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Also ListedInternal MedicineTaxonomy 207R00000X · License 12760 (ND)
2 TERMINAL DR STE 4B, East Alton, IL 62024

Other Identifiers 1

Medicaid18920ND

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

Sumit Tiwari 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 ID5597909952
PECOS Enrollment IDI20200803000994
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 17

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.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
615 services510 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.
386 services279 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
145 services143 patients
Nuclear medicine studies of heart muscle at rest and with stress and spect 78452
Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.
96 services96 patients
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016
An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.
87 services87 patients
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018
An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.
87 services87 patients

Hospital Affiliations CMS Care Compare 5

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

Alton Memorial Hospital

Acute Care Hospitals · Alton, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140002
LocationOne Memorial DriveAlton, IL 62002 · Madison County
Emergency services Birthing friendly

Touchette Regional Hospital Inc

Acute Care Hospitals · Centreville, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number140077
Location5900 Bond AvenueCentreville, IL 62207 · St. Clair County
Emergency services

Memorial Hospital

Acute Care Hospitals · Belleville, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140185
Location4500 Memorial DriveBelleville, IL 62226 · St. Clair County
Emergency services Birthing friendly

Hshs St Elizabeth's Hospital

Acute Care Hospitals · O Fallon, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140187
LocationOne St Elizabeth BoulevardO Fallon, IL 62269 · St. Clair County
Emergency services Birthing friendly

Barnes Jewish Hospital

Acute Care Hospitals · Saint Louis, MO
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number260032
LocationOne Barnes-Jewish Hospital PlazaSaint Louis, MO 63110 · St. Louis City County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62024 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
$131.14 typical visit price
range $56.28 – $173.35
Typical copayment $32.78 (range $14.07 – $43.33)
Most-billed visit code 99204
Established Patient
$70.42 typical visit price
range $17.51 – $139.99
Typical copayment $17.60 (range $4.37 – $34.99)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

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

Automatic external defibrillator, with integrated electrocardiogram analysis, garment type K0606
DME-Other DME · category DE013N
1 supplier26 claims26 services$2,240.56 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

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Federally Qualified Health Center (FQHC))
2 TERMINAL DR STE 4B
EAST ALTON, IL 62024

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 Sumit Tiwari's NPI number?

The NPI number for Sumit Tiwari is 1215048574. It was assigned to this individual provider in the NPPES registry on August 31, 2006.

Where is Sumit Tiwari located?

Sumit Tiwari practices at 2 Terminal Dr Ste 4B, East Alton, IL 62024. The listed phone number is (618) 216-8127.

What is Sumit Tiwari's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Sumit Tiwari enrolled in Medicare?

Yes. Sumit Tiwari 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 Sumit Tiwari accept?

Health plans from UnitedHealthcare list Sumit Tiwari 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 Sumit Tiwari affiliated with any hospitals?

According to CMS data, Sumit Tiwari is affiliated with Alton Memorial Hospital, Touchette Regional Hospital Inc, Memorial Hospital, Hshs St Elizabeth's Hospital and Barnes Jewish Hospital.

When was this NPI record last updated?

The NPPES record for Sumit Tiwari was last updated on May 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.