DR. SUMEDHA SANJIV DALVI M.D.
NPI 1255400321
Internal Medicine in Fayetteville, NC

Q: What is Sumedha Dalvi's NPI number?

The NPI number for Sumedha Dalvi is 1255400321. It was assigned to this individual provider in the NPPES registry on November 6, 2006.

Q: What is Sumedha Dalvi's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Sumedha Dalvi was last updated on October 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since November 06, 2006PECOS EnrolledAccepts Medicare Assignment

40.39/100

CMS Quality Rating

5085 MORGANTON RD, SUITE 100, FAYETTEVILLE, NC 28314(910) 864-0689(910) 864-3747 Get Directions Write a Review

NPPES record last updated: October 14, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Sumedha Sanjiv Dalvi M.d. NPPES

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

DR. SUMEDHA SANJIV DALVI M.D. (NPI 1255400321) is an individual internal medicine provider in Fayetteville, North Carolina, licensed in North Carolina (9800506) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS, is affiliated with Cape Fear Valley Medical Center, and is a graduate of Other (1989).

NPPES Registry Identity

NPI1255400321

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameDR. SUMEDHA SANJIV DALVICredential: M.D.

Location Address5085 MORGANTON RD, SUITE 100Fayetteville, NC 28314-1497

Mailing Address5085 Morganton Rd, Ste 100Fayetteville, NC 28314-1497 · (910) 864-0689 · Fax (910) 864-3747

Phone(910) 864-0689

Fax(910) 864-3747

Sole ProprietorNo

Medical School CMSOtherGraduated 1989

Enumeration DateNovember 6, 2006

Last NPPES UpdateOctober 14, 2019

✔ NPI 1255400321 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in NC · 9800506

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.

5085 MORGANTON RD, Fayetteville, NC 28314

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Other Identifiers 2

Medicaid861015XNC

Other432024077NC · Tax Id

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, UnitedHealthcare.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. Sumedha Sanjiv Dalvi 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 ID3870406663

PECOS Enrollment IDI20031107000412

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 37

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.

Injection, testosterone cypionate, 1 mg J1071

Testosterone cypionate is a medication given via injection to help balance hormone levels in your body. It's typically used when your body doesn't produce enough of this hormone naturally. The 1 mg dose refers to the amount of medication in each injection.

13,201 services16 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.

1,086 services374 patients

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

724 services32 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

348 services125 patients

Injection, ceftriaxone sodium, per 250 mg J0696

Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.

214 services29 patients

Face-to-face behavioral counseling for obesity, 15 minutes G0447

This is a 15-minute consultation where a healthcare professional discusses your eating habits, physical activity, and goals to help manage your weight. The aim is to provide personalized strategies to promote a healthier lifestyle and combat obesity.

169 services110 patients

Assessment of and care planning for patient with impaired thought processing, typically 60 minutes 99483

This service involves a thorough evaluation of your thought processes, which may be impacting your daily life. In a typical 50-minute session, a healthcare professional will assess your cognitive abilities, identify any areas of concern, and develop a personalized care plan to help improve your mental function.

167 services166 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

135 services133 patients

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg J3420

This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.

131 services78 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

115 services115 patients

Evaluation of neuropsychological test, first hour 96132

An evaluation of neuropsychological tests is a process to assess your brain's function. It involves tasks designed to measure cognitive abilities such as memory, attention, problem-solving, and language skills. The first hour involves initial testing and observation.

110 services110 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

81 services81 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

79 services77 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

71 services71 patients

Training in the use of orthopedic device for arm, leg and/or trunk, each 15 minutes 97760

This service involves learning to use an orthopedic device for your arm, leg, or trunk. The training lasts for 15 minutes and helps you understand how to properly use the device to support your recovery and enhance mobility.

70 services38 patients

Complete ultrasound study of arm and leg arteries 93923

This procedure involves using sound waves to produce images of your arm and leg arteries. It helps identify blockages or abnormalities that could lead to conditions like stroke or peripheral artery disease. It's non-invasive and painless.

46 services23 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

44 services42 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less 96365

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

40 services21 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.

38 services34 patients

Injection, ketorolac tromethamine, per 15 mg J1885

Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.

32 services16 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.

30 services30 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.

26 services18 patients

Infusion, normal saline solution, 250 cc J7050

An infusion of normal saline solution, 250 cc, involves administering a sterile saltwater solution into your body through a vein, usually in your arm. This helps to replenish fluids, maintain hydration, and balance electrolytes in your body.

26 services12 patients

Complete ultrasound scan behind abdominal cavity 76770

A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.

23 services22 patients

Evaluation and testing for balance with recording 92540

This procedure involves a series of evaluations and tests to analyze your balance. Recordings are made to track your performance, helping identify any issues. This aids in determining the best treatment for any balance disorders you may have.

23 services23 patients

Test for abnormal eye movement using a rotating chair 92546

A rotating chair test helps doctors assess balance issues. You'll sit in a motorized chair that spins at controlled speeds. As the chair moves, your eye movements are monitored to identify any irregularities, which can indicate balance disorders.

23 services23 patients

Use of electrodes during balance testing 92547

Balance testing with electrodes involves attaching small sensors to your skin. These sensors record your body's responses to various balance tests. They help in assessing your balance and coordination by measuring your body's electrical activity as you perform specific tasks.

23 services23 patients

Ultrasound of both sides of head and neck blood flow 93880

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

23 services23 patients

Testing of autonomic nervous system function and heart rate response to deep breathing 95921

This test studies the autonomic nervous system, which controls body functions like heart rate. During the test, you'll breathe deeply while the heart rate is monitored. This helps identify any irregularities in the heart's response to breathing changes.

23 services23 patients

Testing of autonomic (sympathetic) nervous system function 95923

Testing of autonomic nervous system function assesses how well your body's automatic processes, like heart rate and blood pressure, are working. It involves various non-invasive tests like heart rate variability and sweat production tests.

23 services23 patients

Complete ultrasound scan of abdomen 76700

A complete ultrasound scan of the abdomen is a non-invasive imaging procedure. It uses sound waves to produce images of the organs in your abdomen, such as the liver, gallbladder, spleen, pancreas, and kidneys. It helps in diagnosing, monitoring, and planning treatments.

21 services20 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

17 services14 patients

Infusion, normal saline solution, sterile (500 ml = 1 unit) J7040

An infusion of a normal saline solution is a common medical procedure. Sterile saline (salt water) is administered into your bloodstream via a drip. This helps to maintain fluid balance in your body, especially when you're unable to drink enough liquids.

17 services13 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.

15 services15 patients

Smoking and tobacco use intensive counseling, 4-10 minutes 99406

This service provides brief, intensive counseling (4-10 minutes) to support you in quitting smoking or tobacco use. It involves discussing the risks of tobacco use, benefits of quitting, and strategies to help you stop. It's a critical step towards a healthier lifestyle.

15 services12 patients

Electrocardiogram (ecg) 2-day continuous 93225

An Electrocardiogram (ECG) 2-day continuous is a non-invasive test that records the electrical activity of your heart over 48 hours. It helps to detect irregular heart rhythms, heart disease, or other cardiac conditions. You wear a portable device that records heart activity as you go about your daily activities.

14 services14 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

14 services11 patients

Hospital Affiliations CMS Care Compare

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

Cape Fear Valley Medical Center

Acute Care Hospitals · Fayetteville, NC

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number340028

Location1638 Owen Drive P O Box 2000Fayetteville, NC 28302 · Cumberland County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28314 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

$125.01 typical visit price

range $54.12 – $165.09

Typical copayment $31.25 (range $13.53 – $41.27)

Most-billed visit code 99204

Established Patient

$95.94 typical visit price

range $17.21 – $134.61

Typical copayment $23.98 (range $4.30 – $33.65)

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.

40.39/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

Improvement Activities

Cost

94.64

Reported Quality Measures

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.

94%6,771 patients4/55-star benchmark: 100%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

0%675 patients1/55-star benchmark: 96%

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.

98%66 patients4/55-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.

77%839 patients4/55-star benchmark: 99%

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…

17%839 patients1/55-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…

0%839 patients1/55-star benchmark: 59%

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.

Referred Medical Equipment & Supplies CMS DME claims 12

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

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

2 suppliers11 claims11 services$12.46 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

2 suppliers11 claims66 services$1.94 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

1 supplier21 claims21 services$52.81 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier19 claims19 services$5.95 avg. paid by Medicare

Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) E0630

DME-Other DME · category DE000N

1 supplier11 claims11 services$48.94 avg. paid by Medicare

Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible E0849

DME-Other DME · category DE000N

1 supplier11 claims11 services$27.37 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 11

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

RAPHA HEALTH SYSTEM

Family Medicine