DR. MARK JOHN METWALLY MD
NPI 1316122823
Internal Medicine - Gastroenterology in Burnt Hills, NY

Q: What is Mark Metwally's NPI number?

The NPI number for Mark Metwally is 1316122823. It was assigned to this individual provider in the NPPES registry on January 3, 2008.

Q: What is Mark Metwally's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Mark Metwally was last updated on February 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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 January 03, 2008PECOS EnrolledAccepts Medicare Assignment

26.76/100

CMS Quality Rating

848 ROUTE 50, BURNT HILLS, NY 12027(518) 831-1500(518) 377-1677 Get Directions Write a Review

NPPES record last updated: February 3, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 3, 2025, Dec 13, 2018 (2 updates tracked since 2018).

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About Dr. Mark John Metwally Md NPPES

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

DR. MARK JOHN METWALLY MD (NPI 1316122823) is an individual gastroenterology provider in Burnt Hills, New York, licensed in New York (274634) and active in the NPI registry since January 2008. He is enrolled in Medicare PECOS, is affiliated with St Peter's Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1316122823

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameDR. MARK JOHN METWALLYCredential: MD

Location Address848 ROUTE 50Burnt Hills, NY 12027

Mailing Address848 Route 50Burnt Hills, NY 12027-9511 · (518) 831-1500 · Fax (518) 377-1677

Phone(518) 831-1500

Fax(518) 377-1677

Sole ProprietorNo

Medical School CMSOtherGraduated 2007

Enumeration DateJanuary 3, 2008

Last NPPES UpdateFebruary 3, 20252 updates tracked since enumeration

NPPES CertifiedFebruary 3, 2025

✔ NPI 1316122823 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in NY · 274634

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

848 ROUTE 50, Burnt Hills, NY 12027

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Secondary Practice Locations 2

Location 11 West Ave Ste 130Saratoga Springs, NY 12866-6050 · Phone (518) 831-1500 · Fax (518) 377-1677

Location 21770 Route 9Halfmoon, NY 12065-2495 · Phone (518) 831-1500 · Fax (518) 377-1677

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. Mark John Metwally 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 ID749304343

PECOS Enrollment IDI20140724001571

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 12

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, vedolizumab, intravenous, 1 mg J3380

Vedolizumab is a medication given via injection. It's used to treat certain bowel conditions (such as Crohn's disease, ulcerative colitis) by reducing inflammation. It works by blocking a certain protein that causes this inflammation.

6,000 services12 patients

Injection, infliximab, excludes biosimilar, 10 mg J1745

Infliximab is a medication given via injection to treat certain autoimmune conditions. It works by blocking the action of a substance in your body that causes inflammation. Each dose is based on your medical condition and response to treatment.

1,630 services11 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.

105 services77 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.

88 services81 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

84 services84 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

57 services56 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

45 services45 patients

Administration of chemotherapy into vein, 1 hour or less 96413

Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.

30 services15 patients

Administration of chemotherapy into vein, each additional hour 96415

Chemotherapy is a treatment method that uses drugs to destroy cancer cells. The drugs are administered into a vein, usually in the arm. Each additional hour of chemotherapy allows for more of the medication to enter your bloodstream to fight against the cancer cells.

28 services13 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

20 services20 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

20 services17 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.

19 services12 patients

Hospital Affiliations CMS Care Compare 3

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

St Peter's Hospital

Acute Care Hospitals · Albany, NY

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330057

Location315 South Manning BoulevardAlbany, NY 12208 · Albany County

Emergency services Birthing friendly

Ellis Hospital

Acute Care Hospitals · Schenectady, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330153

Location1101 Nott StreetSchenectady, NY 12308 · Schenectady County

Emergency services Birthing friendly

Saratoga Hospital

Acute Care Hospitals · Saratoga Springs, NY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330222

Location211 Church StreetSaratoga Springs, NY 12866 · Saratoga County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12027 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

$126.40 typical visit price

range $54.87 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

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.

26.76/100

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

Individually scored

Quality

Promoting Interoperability

Improvement Activities

Cost

89.22

Reported Quality Measures

Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk Patients

Percentage of patients aged 50 to 75 years of age receiving a screening colonoscopy without biopsy or polypectomy who had a recommended follow-up interval of at least 10 years for repeat colonoscopy documented in their colonoscopy report

85%65 patients

Appropriate indication for colonoscopy

Percentage of colonoscopy procedures performed for an indication that is included in a published standard list of appropriate indications and the indication is documented

87%593 patients4/55-star benchmark: 99%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

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…

100%145 patients5/55-star benchmark: 100%

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.

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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.

AMY L HETTRICH P.A.

Clinical Nurse Specialist (Adult Health)