1. Home
  2. Directory
  3. Tennessee
  4. Kingsport
  5. Internal Medicine
  6. NPI Profile

DR. MICHAEL ITIDIARE D.O., M.B.S
NPI 1316388556
Internal Medicine - Gastroenterology in Kingsport, TN

Active since July 16, 2013PECOS EnrolledAccepts Medicare Assignment
95.77/100
CMS Quality Rating
130 W RAVINE RD, KINGSPORT, TN 37660(423) 224-4000 Get Directions Write a Review

NPPES record last updated: February 25, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 19, 2021, Jul 22, 2020 (2 updates tracked since 2020).

About Dr. Michael Itidiare D.o., M.b.s NPPES

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

DR. MICHAEL ITIDIARE D.O., M.B.S (NPI 1316388556) is an individual gastroenterology provider in Kingsport, Tennessee, licensed in New Jersey (25MB10130600) and active in the NPI registry since July 2013. He is enrolled in Medicare PECOS, is affiliated with Capital Health Medical Center - Hopewell, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1316388556
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. MICHAEL ITIDIARECredential: D.O., M.B.S
Location Address130 W RAVINE RDKingsport, TN 37660-3837
Mailing Address1 Capital WayPennington, NJ 08534-2520 · (609) 303-4000
Phone(423) 224-4000
Sole ProprietorYes
Medical School CMSOtherGraduated 2013
Enumeration DateJuly 16, 2013
Last NPPES UpdateFebruary 25, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 25, 2026
✔ NPI 1316388556 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Licenses✔ Licensed in NJ · 25MB10130600✔ Licensed in TN · 6450✔ Licensed in VA · 0102208235
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.
Also ListedInternal MedicineTaxonomy 207R00000X · License 6450 (TN), 0102208235 (VA)
130 W RAVINE RD, Kingsport, TN 37660
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11 Capital WayPennington, NJ 08534-2520 · Phone (609) 303-4000
Location 21 Medical Park BlvdBristol, TN 37620-7430 · Phone (423) 844-1121

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. Michael Itidiare D.o., M.b.s 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 ID4385068014
PECOS Enrollment IDI20200728000602, I20241105001009, I20241105001466
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 3

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 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.
87 services43 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
61 services37 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.
57 services55 patients

Hospital Affiliations CMS Care Compare 3

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

Capital Health Medical Center - Hopewell

Acute Care Hospitals · Pennington, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310044
LocationOne Capital WayPennington, NJ 08534 · Mercer County
Emergency services Birthing friendly

Atlanticare Regional Medical Center - City Campus

Acute Care Hospitals · Atlantic City, NJ
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310064
Location1925 Pacific AvenueAtlantic City, NJ 08401 · Atlantic County
Emergency services Birthing friendly

Wellmont Holston Valley Medical Center

Acute Care Hospitals · Kingsport, TN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440017
Location130 West Ravine RoadKingsport, TN 37662 · Sullivan County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37660 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
$121.80 typical visit price
range $52.64 – $160.89
Typical copayment $30.45 (range $13.16 – $40.22)
Most-billed visit code 99204
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
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.

95.77/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality76.75
Promoting Interoperability100
Improvement Activities40

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.

CLAIRE ELLIOTT PHARMD
Pharmacist
130 W RAVINE RD
KINGSPORT, TN 37660
Sullivan County (423) 224-4000
WPS PROVIDERS INC
General Practice
130 W RAVINE RD
KINGSPORT, TN 37660
Sullivan County (423) 224-4000
JAMES ROBERT BECK PHARMACIST
Pharmacist
130 W RAVINE RD, WELLMONT OUTPATIENT PHARMACY
KINGSPORT, TN 37660
Sullivan County (423) 224-6860
MRS. REKHA S GUPTA OTR
Occupational Therapist
130 W RAVINE RD
KINGSPORT, TN 37660
Sullivan County (423) 224-5535
MRS. STACEY ANN RYDER CRNA
Nurse Anesthetist, Certified Registered
130 W RAVINE RD
KINGSPORT, TN 37660
Sullivan County (423) 224-4000
DR. HETVI KIRITKUMAR JOSHI M.D.
Hospitalist
130 W RAVINE RD
KINGSPORT, TN 37660
Sullivan County (423) 224-3628
SHERRY LYNN GOODE NP
Nurse Practitioner (Family)
130 W RAVINE RD
KINGSPORT, TN 37660
Sullivan County (423) 224-3628
PATRINA NICOLYN CRADIC FNP-C
Nurse Practitioner (Family)
130 W RAVINE RD
KINGSPORT, TN 37660
Sullivan County (423) 224-4000

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 Michael Itidiare's NPI number?

The NPI number for Michael Itidiare is 1316388556. It was assigned to this individual provider in the NPPES registry on July 16, 2013.

Where is Michael Itidiare located?

Michael Itidiare practices at 130 W Ravine Rd, Kingsport, TN 37660. The listed phone number is (423) 224-4000.

What is Michael Itidiare's specialty?

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

Is Michael Itidiare enrolled in Medicare?

Yes. Michael Itidiare 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.

Is Michael Itidiare affiliated with any hospitals?

According to CMS data, Michael Itidiare is affiliated with Capital Health Medical Center - Hopewell, Atlanticare Regional Medical Center - City Campus and Wellmont Holston Valley Medical Center.

When was this NPI record last updated?

The NPPES record for Michael Itidiare was last updated on February 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.