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

Q: What is the provider's specialty?

The provider's specialty is Internal Medicine with taxonomy code 207RI0200X and a focus in Infectious Disease.

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: July 19, 2026.

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

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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

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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 2024 & 2026 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

Quality

64.56

Promoting Interoperability

100

Improvement Activities

Cost

48.54

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.

ELLA HISTAND RN

Registered Nurse (Case Management)