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DR. VISHAL SETHI M.D
NPI 1225251440
Internal Medicine - Infectious Disease in Baltimore, MD

Active since April 10, 2007PECOS Enrolled
76.58/100
CMS Quality Rating
1040 PARK AVE STE 200, BALTIMORE, MD 21201(443) 738-0300(443) 738-0301 Get Directions Write a Review

NPPES record last updated: June 16, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 16, 2018, May 9, 2018 (2 updates tracked since 2018).

About Dr. Vishal Sethi M.d NPPES

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

DR. VISHAL SETHI M.D (NPI 1225251440) is an individual infectious disease provider in Baltimore, Maryland, licensed in Maryland (D0070809) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS, is affiliated with Sinai Hospital Of Baltimore, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1225251440
Entity TypeIndividualMale
Primary Taxonomy207RI0200X
Provider Legal NameDR. VISHAL SETHICredential: M.D
Location Address1040 PARK AVE STE 200Baltimore, MD 21201-5634
Mailing Address2140 Peachtree Rd Nw Ste 232Atlanta, GA 30309-1316 · (404) 231-4431 · Fax (404) 231-5677
Phone(443) 738-0300
Fax(443) 738-0301
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateApril 10, 2007
Last NPPES UpdateJune 16, 20182 updates tracked since enumeration
✔ NPI 1225251440 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
License✔ Licensed in MD · D0070809
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
1040 PARK AVE STE 200, Baltimore, MD 21201
Open in Google Maps ↗

Other Identifiers 1

Medicaid132190100MD

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Vishal Sethi M.d is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9931395779
PECOS Enrollment IDI20101119000102
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 6

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.
457 services180 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.
130 services129 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
73 services72 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
33 services27 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.
16 services15 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.
14 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Sinai Hospital Of Baltimore

Acute Care Hospitals · Baltimore, MD
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number210012
Location2401 West Belvedere AvenueBaltimore, MD 21215 · Baltimore City County
Emergency services Birthing friendly

Levindale Hebrew Geriatric Center And Hospital

Acute Care Hospitals · Baltimore, MD
OwnershipVoluntary non-profit - Private
CMS Certification Number210064
Location2434 West Belvedere AvenueBaltimore, MD 21209 · Baltimore City County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21201 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
$139.05 typical visit price
range $60.73 – $183.44
Typical copayment $34.76 (range $15.18 – $45.86)
Most-billed visit code 99204
Established Patient
$106.59 typical visit price
range $19.60 – $149.17
Typical copayment $26.64 (range $4.90 – $37.29)
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.

76.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality64.56
Promoting Interoperability100
Improvement Activities40
Cost48.54

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.

CARRIE A. JONECKIS PA-C
Physician Assistant (Medical)
1040 PARK AVE STE 200
BALTIMORE, MD 21201
Baltimore City (443) 738-0300
ELIZABETH ANNE GILLIAMS MD
Internal Medicine
1040 PARK AVE STE 200
BALTIMORE, MD 21201
Baltimore City (443) 738-0300
DR. ANIKA ADERO HARDIE ALVANZO MD, MS
Internal Medicine
1040 PARK AVE STE 200
BALTIMORE, MD 21201
Baltimore City (443) 738-0300
ABSOLUTECARE OF BALTIMORE, LLC
Family Medicine
1040 PARK AVE STE 200
BALTIMORE, MD 21201
Baltimore City (443) 738-0300
VIANCA J MASUCCI MD
Internal Medicine
1040 PARK AVE STE 200
BALTIMORE, MD 21201
Baltimore City (443) 738-0300
NIMITA SHARMA PHARM.D
Pharmacist (Ambulatory Care)
1040 PARK AVE STE 200
BALTIMORE, MD 21201
Baltimore City (443) 738-0240
CAROL GAREY LCSW-C
Social Worker (Clinical)
1040 PARK AVE STE 200
BALTIMORE, MD 21201
Baltimore City (443) 738-0300
KELLI MCCALLUM CRNP
Nurse Practitioner (Family)
1040 PARK AVE STE 200
BALTIMORE, MD 21201
Baltimore City (443) 738-0300

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 Vishal Sethi's NPI number?

The NPI number for Vishal Sethi is 1225251440. It was assigned to this individual provider in the NPPES registry on April 10, 2007.

Where is Vishal Sethi located?

Vishal Sethi practices at 1040 Park Ave Ste 200, Baltimore, MD 21201. The listed phone number is (443) 738-0300.

What is Vishal Sethi's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Vishal Sethi enrolled in Medicare?

Yes. Vishal Sethi is registered in the Medicare PECOS enrollment system.

Is Vishal Sethi affiliated with any hospitals?

According to CMS data, Vishal Sethi is affiliated with Sinai Hospital Of Baltimore and Levindale Hebrew Geriatric Center And Hospital.

When was this NPI record last updated?

The NPPES record for Vishal Sethi was last updated on June 16, 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.