DR. MUHAMMAD JAWAD SETHI M.D., M.B;B.S
NPI 1275762130
Internal Medicine - Endocrinology, Diabetes & Metabolism in Tucson, AZ

NPI Status: Active since July 13, 2009

Contact Information

6236 E PIMA ST STE 100
TUCSON, AZ
ZIP 85712
Phone: (520) 886-5534
Fax: (520) 886-5577

Recently Updated NPI Information
Some details in this NPI profile have been updated in the NPI registry within the last 30 days.

Table of Contents

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Durable Medical Equipment
Physician Visit Costs
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 23
Internal Medicine
Endocrinology, Diabetes & Metabolism
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About MUHAMMAD SETHI

This page provides the complete NPI Profile along with additional information for Muhammad Sethi, an internist established in Tucson, Arizona with a medical specialization in Internal Medicine, focusing in endocrinology, diabetes & metabolism and more than 23 years of experience. The healthcare provider is registered in the NPI registry with number 1275762130 assigned on July 2009. The practitioner's primary taxonomy code is 207RE0101X with license number 46978 (AZ). The provider is registered as an individual and his NPI record was last updated June 2026.

NPI: 1275762130
Provider Name: DR. MUHAMMAD JAWAD SETHI M.D., M.B;B.S
Gender: Male
Entity Type: Individual
Location Address: 6236 E PIMA ST STE 100 TUCSON, AZ 85712
Location Phone: (520) 886-5534
Location Fax: (520) 886-5577
Mailing Address: 4801 E BROADWAY BLVD STE 251 TUCSON, AZ 85711
Mailing Phone: (520) 382-1205
Mailing Fax: (520) 886-5577
Medical School Name: OTHER
Graduation Year: 2004
Is Sole Proprietor?: No
Enumeration Date: 07-13-2009
Last Update Date: 06-19-2026
Code Navigator

An internist like Muhammad Sethi is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Internal Medicine Endocrinology, Diabetes & Metabolism
Taxonomy Code: 207RE0101X
Type: Allopathic & Osteopathic Physicians
License No.: 46978
License State: AZ
Taxonomy Description: An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	207RE0101X	Allopathic & Osteopathic Physicians	Internal Medicine Endocrinology, Diabetes & Metabolism	12928 (ND)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Ambetter from Arizona Complete Health

Choice Bronze HSA - HMO
Choice Bronze HSA + Vision + Adult Dental - HMO
Complete Gold - HMO
Complete Gold + Vision + Adult Dental - HMO
Complete Silver - HMO
Complete Silver + Vision + Adult Dental - HMO
Elite Gold - HMO
Elite Gold + Vision + Adult Dental - HMO
Everyday Bronze - HMO
Everyday Bronze + Vision + Adult Dental - HMO
Standard Expanded Bronze - HMO
Standard Expanded Bronze + Vision + Adult Dental - HMO
Standard Gold - HMO
Standard Gold + Vision + Adult Dental - HMO
Standard Silver - HMO
Standard Silver + Vision + Adult Dental - HMO

Blue Cross Blue Shield of Arizona

AZ Blue ACA StandardHealth Silver with Health Choice - HMO
AZ Blue AdvanceHealth Bronze Focus (4 Free PCP Visits) - HMO
AZ Blue AdvanceHealth Bronze Neighborhood (4 Free PCP Visits) - HMO
AZ Blue AdvanceHealth Gold Focus (4 Free PCP Visits) - HMO
AZ Blue AdvanceHealth Gold Neighborhood (4 Free PCP Visits) - HMO
AZ Blue AdvanceHealth Silver Focus (4 Free PCP Visits) - HMO
AZ Blue AdvanceHealth Silver Neighborhood (4 Free PCP Visits) - HMO
AZ Blue EverydayHealth Gold Focus (1 Free PCP Visit) - HMO
AZ Blue EverydayHealth Gold Neighborhood (1 Free PCP Visit) - HMO
AZ Blue EverydayHealth Prosano Gold ($0 Prosano Health Visits) - HMO
AZ Blue EverydayHealth Prosano Silver ($0 Prosano Health Visits) - HMO
AZ Blue EverydayHealth Silver Focus (1 Free PCP Visit) - HMO
AZ Blue EverydayHealth Silver Neighborhood (1 Free PCP Visit) - HMO
AZ Blue Portfolio Bronze HSA Focus - HMO
AZ Blue Portfolio Bronze HSA Neighborhood - HMO
AZ Blue StandardHealth Bronze Focus - HMO
AZ Blue StandardHealth Bronze Neighborhood - HMO
AZ Blue StandardHealth Gold Focus - HMO
AZ Blue StandardHealth Gold Neighborhood - HMO
AZ Blue StandardHealth Silver Focus - HMO

Oscar Health Plan, Inc.

Bronze Classic Standard - HMO
Bronze Elite + PCP Saver Plus - HMO
Bronze Simple - HMO
Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
Bronze Simple Chronic Care CKM - HMO
Buena Salud Bronce Simple Para Diabetes - HMO
Gold Classic - HMO
Gold Classic Standard - HMO
Gold Simple - HMO
Gold Simple Diabetes - HMO
Silver Classic Standard - HMO
Silver Elite Saver Plus - HMO
Silver Simple Chronic Care CKM - HMO
Silver Simple Diabetes - HMO
Silver Simple PCP Saver - HMO
Silver Simple Specialist Saver with COPD - HMO
Silver Simple Women's Health with Menopause Benefits - HMO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
787840	MEDICAID (05)	AZ

Medicare Participation & PECOS Enrollment Status

Muhammad Sethi is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Muhammad Sethi is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 5294970380
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20130320000310
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

DME-Other DME (DE017N)
Supplies for maintenance of insulin infusion catheter, per week (HCPCS:A4224)
7 DME suppliers used 45 Medicare Claims 583 Services Paid
DME-Other DME (DE017N)
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each (HCPCS:A4225)
7 DME suppliers used 43 Medicare Claims 1300 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Supply allowance for adjunctive continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:A4238)
4 DME suppliers used 42 Medicare Claims 42 Services Paid
DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
30 DME suppliers used 73 Medicare Claims 310 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Lancets, per box of 100 (HCPCS:A4259)
12 DME suppliers used 15 Medicare Claims 28 Services Paid
DME-Other DME (DE017N)
External ambulatory infusion pump, insulin (HCPCS:E0784)
4 DME suppliers used 39 Medicare Claims 39 Services Paid
DME-Other DME (DE017N)
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)
19 DME suppliers used 547 Medicare Claims 556 Services Paid
DME-Other DME (DE017N)
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system (HCPCS:K0554)
5 DME suppliers used 19 Medicare Claims 19 Services Paid

Unknown

Treatment-Injections and Infusions (nononcologic) (RI000N)
Insulin for administration through dme (i.e., insulin pump) per 50 units (HCPCS:J1817)
11 DME suppliers used 38 Medicare Claims 4180 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Blood test, basic group of blood chemicals (calcium, total)
Blood test, comprehensive group of blood chemicals
Blood test, lipids (cholesterol and triglycerides)
Blood test, thyroid stimulating hormone (tsh)
Complete blood cell count (red cells, white blood cell, platelets), automated test
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report
Creatinine level to test for kidney function or muscle injury
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
Gonadotropin, follicle stimulating (reproductive hormone) level
Gonadotropin, luteinizing (reproductive hormone) level
Hemoglobin a1c level
Insertion of needle into vein for collection of blood sample
Magnesium level
Microscopic examination for white blood cells with manual cell count
Microsomal antibodies (autoantibody) measurement
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
Parathormone (parathyroid hormone) level
Phosphate level
Prolactin (milk producing hormone) level
Sex hormone binding globulin (protein) level
Testosterone (hormone) level, total
Thyroglobulin (thyroid protein) antibody measurement
Thyroglobulin (thyroid related hormone) level
Thyroid hormone, t3 measurement, free
Thyroxine (thyroid chemical), free
Urine microalbumin (protein) level
Vitamin d-3 level

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.92 for a new patient copayment and $24.5 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 85712 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $127.71
Minimum New Patient Price $55.44
Maximum New Patient Price $168.6

Average New Patient Copayment $31.92
Minimum New Patient Copayment $13.86
Maximum New Patient Copayment $42.15

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $98
Minimum Established Patient Price $17.72
Maximum Established Patient Price $137.41

Average Established Patient Copayment $24.5
Minimum Established Patient Copayment $4.43
Maximum Established Patient Copayment $34.35

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Chronic Care and Preventative Care Management for Empaneled Patients	Yes	N/A
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
Colorectal Cancer Screening	42%	1039
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Diabetes: Eye Exam	51%	581
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
e-Prescribing	94%	7292
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Health Information Exchange	71%	920
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 at least one transition of care or referral.
Implementation of medication management practice improvements	Yes	N/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Measurement and Improvement at the Practice and Panel Level	Yes	N/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Medication Reconciliation	100%	1419
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.
Patient-Specific Education	87%	2403
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.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	40%	2315
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Provide Patient Access	100%	2403
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 certain information.
Secure Messaging	57%	2403
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 message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.
Use of decision support and standardized treatment protocols	Yes	N/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1275762130, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 14 → 1 + 4

Pos 4

Unchanged

Pos 5

Doubled → 14 → 1 + 4

Pos 6

Unchanged

Pos 7

Doubled → 4

Pos 8

Unchanged

Pos 9

Doubled → 6

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 7 → 14 → 5 2 → 4 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 4 + 5 + 1 + 4 + 6 + 4 + 1 + 6 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0

This NPI is valid

The calculated check digit is 0, which matches the last digit of 1275762130.