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SARWAN KUMAR SETH MD
NPI 1295765527
Family Medicine - Adult Medicine in East Orange, NJ

Active since July 03, 2006PECOS EnrolledAccepts Medicare Assignment
94.95/100
CMS Quality Rating
310 CENTRAL AVE, 100, EAST ORANGE, NJ 07018(973) 674-2242(973) 674-8033 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Sarwan Kumar Seth Md NPPES

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

SARWAN KUMAR SETH MD (NPI 1295765527) is an individual adult medicine provider in East Orange, New Jersey, licensed in New Jersey (MA38057) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Englewood Hospital And Medical Center, and is a graduate of Other (1968).

NPPES Registry Identity

NPI1295765527
Entity TypeIndividualMale
Primary Taxonomy207QA0505X
Provider Legal NameSARWAN KUMAR SETHCredential: MD
Location Address310 CENTRAL AVE, 100East Orange, NJ 07018-2835
Mailing Address310 Central Ave, 100East Orange, NJ 07018-2835 · (973) 674-2242 · Fax (973) 674-8033
Phone(973) 674-2242
Fax(973) 674-8033
Sole ProprietorYes
Medical School CMSOtherGraduated 1968
Enumeration DateJuly 3, 2006
Last NPPES UpdateJuly 9, 2007
✔ NPI 1295765527 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
License✔ Licensed in NJ · MA38057
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
310 CENTRAL AVE, East Orange, NJ 07018
Open in Google Maps ↗

Other Identifiers 2

Medicare UPINC53735NJ
Medicare ID-Type Unspecified665257NJ

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.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

Sarwan Kumar Seth 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 ID648296640
PECOS Enrollment IDI20051019000564
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 nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
406 services74 patients
Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348
An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.
137 services25 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.
82 services37 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.
25 services20 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.
19 services19 patients
Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306
An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
17 services17 patients

Hospital Affiliations CMS Care Compare 2

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

Englewood Hospital And Medical Center

Acute Care Hospitals · Englewood, NJ
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310045
Location350 Engle StEnglewood, NJ 07631 · Bergen County
Emergency services Birthing friendly

Cooperman Barnabas Medical Center

Acute Care Hospitals · Livingston, NJ
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310076
Location94 Old Short Hills RoadLivingston, NJ 07039 · Essex County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07018 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
$98.09 typical visit price
range $63.84 – $190.92
Typical copayment $24.52 (range $15.96 – $47.73)
Most-billed visit code 99203
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
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.

94.95/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality87.26
Promoting Interoperability100
Improvement Activities40

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.
78%1,154 patients3/55-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.
49%337 patients2/55-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…
41%337 patients2/55-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%337 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 5

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

Tracheostomy, inner cannula A4623
DME-Orthotic Devices · category DF000N
1 supplier14 claims450 services$6.33 avg. paid by Medicare
Tracheostomy care kit for established tracheostomy A4629
DME-Orthotic Devices · category DF000N
1 supplier21 claims630 services$4.10 avg. paid by Medicare
Tracheostomy tube collar/holder, each A7526
DME-Orthotic Devices · category DF000N
1 supplier14 claims420 services$3.16 avg. paid by Medicare
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034
Other-Enteral and Parenteral · category OB006N
1 supplier16 claims357 services$2.63 avg. paid by Medicare
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152
Other-Enteral and Parenteral · category OB006N
1 supplier16 claims7,624 services$0.22 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 20

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

DR. VICTOR T VERLEZZA D.C.
Chiropractor
310 CENTRAL AVE, SUITE 307
EAST ORANGE, NJ 07018
Essex County (973) 266-7860
DR. NABEEL OBAID MD
Internal Medicine (Infectious Disease)
310 CENTRAL AVE, SUITE 102
EAST ORANGE, NJ 07018
Essex County (201) 512-9494
LIANMED INC
Internal Medicine (Infectious Disease)
310 CENTRAL AVE, SUITE 102
EAST ORANGE, NJ 07018
Essex County (201) 512-9494
ESSEX VALLEY SPINE CARE PC
Chiropractor (Rehabilitation)
310 CENTRAL AVE, SUITE 307
EAST ORANGE, NJ 07018
Essex County (973) 266-7860
SMITH CENTER FOR INFECTIOUS DISEASES AND URBAN HEALTH, P.A.
Voluntary or Charitable
310 CENTRAL AVE, SUITE 307- TIMESHARE
EAST ORANGE, NJ 07018
Essex County (973) 809-4550
ORANGE MEDICAL GROUP PA
Internal Medicine (Hematology & Oncology)
310 CENTRAL AVE, SUITE 106
EAST ORANGE, NJ 07018
Essex County (973) 674-4542
EAST ORANGE PHARMACY LLC
Pharmacy (Community/Retail Pharmacy)
310 CENTRAL AVE, STE 111
EAST ORANGE, NJ 07018
Essex County (973) 674-5777
A1 MEDICAL CARE PC
Clinic/Center (Primary Care)
310 CENTRAL AVE, SUITE 310
EAST ORANGE, NJ 07018
Essex County (973) 678-2900

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 Sarwan Seth's NPI number?

The NPI number for Sarwan Seth is 1295765527. It was assigned to this individual provider in the NPPES registry on July 3, 2006.

Where is Sarwan Seth located?

Sarwan Seth practices at 310 Central Ave 100, East Orange, NJ 07018. The listed phone number is (973) 674-2242.

What is Sarwan Seth's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

Is Sarwan Seth enrolled in Medicare?

Yes. Sarwan Seth 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 Sarwan Seth accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Sarwan Seth 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 Sarwan Seth affiliated with any hospitals?

According to CMS data, Sarwan Seth is affiliated with Englewood Hospital And Medical Center and Cooperman Barnabas Medical Center.

When was this NPI record last updated?

The NPPES record for Sarwan Seth was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.