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CHANDA SHIVANC SETHI-DIHENIA M.D.
NPI 1326036450
Internal Medicine in Lubbock, TX

Active since October 12, 2005PECOS EnrolledAccepts Medicare Assignment
97.4/100
CMS Quality Rating
3601 4TH ST, LUBBOCK, TX 79430(806) 743-3150(806) 743-3168 Get Directions Write a Review

NPPES record last updated: August 20, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 20, 2026, Jan 11, 2021, Aug 22, 2018 (3 updates tracked since 2018).

About Chanda Shivanc Sethi-dihenia M.d. NPPES

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

CHANDA SHIVANC SETHI-DIHENIA M.D. (NPI 1326036450) is an individual internal medicine provider in Lubbock, Texas, licensed in Texas (K3157) and active in the NPI registry since October 2005. She is enrolled in Medicare PECOS, is affiliated with Highlands Arh Regional Medical Center, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (1992).

NPPES Registry Identity

NPI1326036450
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameCHANDA SHIVANC SETHI-DIHENIACredential: M.D.
Location Address3601 4TH STLubbock, TX 79430
Mailing AddressPo Box 5865Lubbock, TX 79408-5865 · (806) 743-3150 · Fax (806) 743-3168
Phone(806) 743-3150
Fax(806) 743-3168
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 1992
Enumeration DateOctober 12, 2005
Last NPPES UpdateAugust 20, 20263 updates tracked since enumeration
NPPES CertifiedAugust 20, 2026
✔ NPI 1326036450 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in TX · K3157
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.
Also ListedHospitalistTaxonomy 208M00000X · License K3157 (TX)
3601 4TH ST, Lubbock, TX 79430
Open in Google Maps ↗

Other Identifiers 10

Other87832ZTX · Hmo Blue
Medicaid124233106TX
Other37070NM · Presbyterian Commercial
Other100150107TX · Firstcare Commercial
Medicaid66744NM
Other8B2605TX · Bc/bs
OtherA006Triwest
Medicaid200042450AOK
Other100150105TX · Firstcare Commercial
Medicaid100150106TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Chanda Shivanc Sethi-dihenia 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 ID6800867284
PECOS Enrollment IDI20210113000855
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.

Medicare Billing Reassignments

8

Medicare enrollment records show Chanda Sethi-dihenia reassigns Medicare billing to 8 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Hospitalist Medicine Physicians Of Texas, PLLC
456 mi
Internal Medicine
18951 N MEMORIAL DR
Humble, TX 77338
  • Reassigned Medicare billing, Texas enrollment
  • 2,009 clinicians in this Medicare group
NPI 1629307095 (281) 540-7700
Commonwealth Health Corporation, Inc
839 mi
Specialist
1011 S MAIN ST
Hopkinsville, KY 42240
  • Reassigned Medicare billing, Kentucky enrollment
  • 319 clinicians in this Medicare group
NPI 1861979304 (270) 253-3147
Southeastern Physician Services PC
1,010 mi
Hospitalist
990 OAK RIDGE TPKE
Oak Ridge, TN 37830
  • Reassigned Medicare billing, Kentucky enrollment
  • 358 clinicians in this Medicare group
NPI 1083835441 (865) 481-1000
Mvhe Inc
1,040 mi
Internal Medicine
5971 GOLF CLUB LN
Hamilton, OH 45011
  • Reassigned Medicare billing, Ohio enrollment
  • 744 clinicians in this Medicare group
NPI 1174631725 (513) 785-4339
Upper Valley Professional Corporation
1,068 mi
Family Medicine
3130 N COUNTY ROAD 25A
Troy, OH 45373
  • Reassigned Medicare billing, Ohio enrollment
  • 405 clinicians in this Medicare group
NPI 1407872518 (937) 440-7497
Arh Tug Valley Health Services, Inc.
1,090 mi
Multi-Specialty
787 PARKWAY DR
Salyersville, KY 41465
  • Reassigned Medicare billing, Kentucky enrollment
  • 242 clinicians in this Medicare group
NPI 1942962105 (606) 349-3511
Centennial Physician Services, PC
1,107 mi
Internal Medicine
130 W RAVINE RD
Kingsport, TN 37660
  • Reassigned Medicare billing, Tennessee enrollment
  • 23 clinicians in this Medicare group
NPI 1871436022 (423) 224-4000
Sotx Hospitalist Associates PLLC
  • Reassigned Medicare billing, Texas enrollment
  • 4 clinicians in this Medicare group
No phone listed

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

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.
238 services89 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.
77 services77 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.
69 services33 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
45 services45 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
43 services43 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
39 services39 patients

Hospital Affiliations CMS Care Compare 5

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

Highlands Arh Regional Medical Center

Acute Care Hospitals · Prestonsburg, KY
2/5 CMS rating
OwnershipProprietary
CMS Certification Number180005
Location5000 Kentucky Route 321Prestonsburg, KY 41653 · Floyd County
Emergency services Birthing friendly

The Medical Center (bowling Green)

Acute Care Hospitals · Bowling Green, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180013
Location250 Park StreetBowling Green, KY 42101 · Warren County
Emergency services Birthing friendly

Middlesboro Arh Hospital

Acute Care Hospitals · Middlesboro, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180020
Location3600 West Cumberland AvenueMiddlesboro, KY 40965 · Bell County
Emergency services Birthing friendly

Fort Duncan Medical Center

Acute Care Hospitals · Eagle Pass, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450092
Location3333 N Foster Maldonado BlvdEagle Pass, TX 78852 · Maverick County
Emergency services Birthing friendly

Covenant Childrens Hospital

Childrens · Lubbock, TX
OwnershipVoluntary non-profit - Private
CMS Certification Number453306
Location4015 22nd PlaceLubbock, TX 79410 · Lubbock County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 79430 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 $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

97.4/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality76.55
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 2

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers18 claims18 services$16.67 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers18 claims18 services$80.48 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.

JAMES STEVEN DEMBOWSKI PHD
Speech-Language Pathologist
3601 4TH ST, STE. 2A300
LUBBOCK, TX 79430
Lubbock County (806) 743-5678
CHARLES KIM D.O.
Anesthesiology
3601 4TH ST
LUBBOCK, TX 79430
Lubbock County (806) 743-3004
BAILEY WADDINGTON MD
Student in an Organized Health Care Education/Training Program
3601 4TH ST
LUBBOCK, TX 79430
Lubbock County (806) 743-6840
SARA SYED AHMED MD
Psychiatry & Neurology (Psychiatry)
3601 4TH ST
LUBBOCK, TX 79430
Lubbock County (806) 743-2800
DR. SAFAA S. LABIB M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
3601 4TH ST, SUITE 1A115
LUBBOCK, TX 79430
Lubbock County (806) 743-2155
MATTHEW PAUL FERGUSON M.D.
Orthopaedic Surgery (Sports Medicine)
3601 4TH ST
LUBBOCK, TX 79430
Lubbock County (806) 743-2475
KORY NOEL HOWELL DO
Student in an Organized Health Care Education/Training Program
3601 4TH ST
LUBBOCK, TX 79430
Lubbock County (806) 743-3381
JANICE STACHOWIAK M.D.
Internal Medicine
3601 4TH ST
LUBBOCK, TX 79430
Lubbock County (806) 743-3150

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 Chanda Sethi-dihenia's NPI number?

The NPI number for Chanda Sethi-dihenia is 1326036450. It was assigned to this individual provider in the NPPES registry on October 12, 2005.

Where is Chanda Sethi-dihenia located?

Chanda Sethi-dihenia practices at 3601 4th St, Lubbock, TX 79430. The listed phone number is (806) 743-3150.

What is Chanda Sethi-dihenia's specialty?

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

Is Chanda Sethi-dihenia enrolled in Medicare?

Yes. Chanda Sethi-dihenia 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.

Which organizations bill Medicare for Chanda Sethi-dihenia's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Chanda Sethi-dihenia reassigns Medicare benefits to 8 organizations: Hospitalist Medicine Physicians Of Texas, PLLC (Humble, TX), Commonwealth Health Corporation, Inc (Hopkinsville, KY), Southeastern Physician Services PC (Oak Ridge, TN), Mvhe Inc (Hamilton, OH), Upper Valley Professional Corporation (Troy, OH) and 3 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Chanda Sethi-dihenia's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Chanda Sethi-dihenia accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee, Anthem Blue Cross and Blue Shield and Blue Cross and Blue Shield of Texas and 1 other insurer list Chanda Sethi-dihenia 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 Chanda Sethi-dihenia affiliated with any hospitals?

According to CMS data, Chanda Sethi-dihenia is affiliated with Highlands Arh Regional Medical Center, The Medical Center (bowling Green), Middlesboro Arh Hospital, Fort Duncan Medical Center and Covenant Childrens Hospital.

When was this NPI record last updated?

The NPPES record for Chanda Sethi-dihenia was last updated on August 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.