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DR. SUNITA PAUDYAL MD
NPI 1225230949
Internal Medicine - Rheumatology in Columbia, SC

Active since June 04, 2007PECOS EnrolledAccepts Medicare Assignment
99.32/100
CMS Quality Rating
2 MEDICAL PARK ROAD, SUITE 501, COLUMBIA, SC 29203(803) 540-1000(803) 540-1075 Get Directions Write a Review

NPPES record last updated: April 5, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Sunita Paudyal Md NPPES

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

DR. SUNITA PAUDYAL MD (NPI 1225230949) is an individual rheumatology provider in Columbia, South Carolina, licensed in South Carolina (39206) and active in the NPI registry since June 2007. She is enrolled in Medicare PECOS, is affiliated with Prisma Health Richland Hospital, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1225230949
Entity TypeIndividualFemale
Primary Taxonomy207RR0500X
Provider Legal NameDR. SUNITA PAUDYALCredential: MD
Location Address2 MEDICAL PARK ROAD, SUITE 501Columbia, SC 29203-6839
Mailing AddressPo Box 743904Atlanta, GA 30374-3904 · (803) 296-7320 · Fax (803) 296-7330
Phone(803) 540-1000
Fax(803) 540-1075
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateJune 4, 2007
Last NPPES UpdateApril 5, 2018
✔ NPI 1225230949 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
License✔ Licensed in SC · 39206
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
Also ListedInternal MedicineTaxonomy 207R00000X · License 39206 (SC), MD126236 (OR)
2 MEDICAL PARK ROAD, Columbia, SC 29203
Open in Google Maps ↗

Other Identifiers 3

Medicaid392060SC
OtherMD126236OR · Or Medical Board
Other39206SC · License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina.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. Sunita Paudyal 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 ID941355606
PECOS Enrollment IDI20160728001019
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.
322 services171 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.
38 services38 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.
19 services18 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
18 services18 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
13 services13 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.
12 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Prisma Health Richland Hospital

Acute Care Hospitals · Columbia, SC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number420018
Location5 Medical ParkColumbia, SC 29203 · Richland County
Emergency services Birthing friendly

Prisma Health Baptist

Acute Care Hospitals · Columbia, SC
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number420086
Location1330 Taylor At Marion StColumbia, SC 29220 · Richland County
Emergency services Birthing friendly

Prisma Health Baptist Parkridge

Acute Care Hospitals · Columbia, SC
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number420106
Location400 Palmetto Health ParkwayColumbia, SC 29212 · Lexington County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29203 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
$124.04 typical visit price
range $53.57 – $163.84
Typical copayment $31.01 (range $13.39 – $40.96)
Most-billed visit code 99204
Established Patient
$95.12 typical visit price
range $16.96 – $133.52
Typical copayment $23.78 (range $4.24 – $33.38)
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.

99.32/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality90.59
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 2

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

BROOKE SHAVON MCADAMS MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
2 MEDICAL PARK ROAD, SUITE 506
COLUMBIA, SC 29203
Richland County (803) 434-3930
ALBERTO SAENZ MD
Internal Medicine (Cardiovascular Disease)
2 MEDICAL PARK ROAD, SUITE 506
COLUMBIA, SC 29203
Richland County (803) 540-1000

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 Sunita Paudyal's NPI number?

The NPI number for Sunita Paudyal is 1225230949. It was assigned to this individual provider in the NPPES registry on June 4, 2007.

Where is Sunita Paudyal located?

Sunita Paudyal practices at 2 Medical Park Road Suite 501, Columbia, SC 29203. The listed phone number is (803) 540-1000.

What is Sunita Paudyal's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Sunita Paudyal enrolled in Medicare?

Yes. Sunita Paudyal 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 Sunita Paudyal accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina and BlueCross BlueShield of South Carolina list Sunita Paudyal 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 Sunita Paudyal affiliated with any hospitals?

According to CMS data, Sunita Paudyal is affiliated with Prisma Health Richland Hospital, Prisma Health Baptist and Prisma Health Baptist Parkridge.

When was this NPI record last updated?

The NPPES record for Sunita Paudyal was last updated on April 5, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.