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MR. LAL KUMAR TANWANI M.D.
NPI 1336133347
Internal Medicine in Louisville, KY

Active since September 06, 2005PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
1900 BLUEGRASS AVE, SUITE 108, LOUISVILLE, KY 40215(502) 361-2524(502) 361-2525 Get Directions Write a Review

NPPES record last updated: May 23, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 16, 2016, Feb 24, 2016 (2 updates tracked since 2016).

About Mr. Lal Kumar Tanwani M.d. NPPES

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

MR. LAL KUMAR TANWANI M.D. (NPI 1336133347) is an individual internal medicine provider in Louisville, Kentucky, licensed in Kentucky (35300) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Jewish Hospital & St Mary's Healthcare, and is a graduate of Other (1992).

NPPES Registry Identity

NPI1336133347
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameMR. LAL KUMAR TANWANICredential: M.D.
Location Address1900 BLUEGRASS AVE, SUITE 108Louisville, KY 40215-1144
Mailing Address1900 Bluegrass Ave, Suite 108Louisville, KY 40215-1144 · (502) 361-2524 · Fax (502) 361-2525
Phone(502) 361-2524
Fax(502) 361-2525
Sole ProprietorNo
Medical School CMSOtherGraduated 1992
Enumeration DateSeptember 6, 2005
Last NPPES UpdateMay 23, 20162 updates tracked since enumeration
✔ NPI 1336133347 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 KY · 35300
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 ListedInternal Medicine · Endocrinology, Diabetes & MetabolismTaxonomy 207RE0101X · License 35300 (KY), 01063197A (IN)
1900 BLUEGRASS AVE, Louisville, KY 40215
Open in Google Maps ↗

Other Identifiers 6

Medicaid200855050A (KOHMG)IN
Medicare PIN0997801KY
Medicare UPINH69360
Medicaid64055551KY
Medicare PINK197490 (KOHMG)KY
Medicare PINP01634710 RR (KOHMG)KY

Accepted Insurance

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

Mr. Lal Kumar Tanwani 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 ID1355359845
PECOS Enrollment IDI20060328000013
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 10

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.

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.
576 services231 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
506 services227 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.
205 services131 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
184 services72 patients
Urine microalbumin (protein) level 82043
The urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.
49 services49 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.
45 services43 patients

Hospital Affiliations CMS Care Compare 2

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

Jewish Hospital & St Mary's Healthcare

Acute Care Hospitals · Louisville, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180040
Location200 Abraham Flexner WayLouisville, KY 40202 · Jefferson County
Emergency services

University Of Louisville Hospital

Acute Care Hospitals · Louisville, KY
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180141
Location530 South Jackson StreetLouisville, KY 40202 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40215 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
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored

Reported Quality Measures

Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
85%1,024 patients4/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
99%4,700 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
64%709 patients3/55-star benchmark: 90%
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…
68%1,782 patients3/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
36%2,248 patients2/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients tobacco: 100% · 1,391 patients
100%1,391 patients
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 709 patients
0%709 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.

Referred Medical Equipment & Supplies CMS DME claims 8

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

Supplies for maintenance of insulin infusion catheter, per week A4224
DME-Other DME · category DE017N
3 suppliers19 claims240 services$18.26 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
3 suppliers19 claims570 services$2.25 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
46 suppliers179 claims666 services$6.36 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
5 suppliers24 claims24 services$2.94 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
27 suppliers78 claims165 services$1.10 avg. paid by Medicare
External ambulatory infusion pump, insulin E0784
DME-Other DME · category DE017N
2 suppliers32 claims32 services$294.05 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.

ANDREA E PORTER APRN
Nurse Practitioner
1900 BLUEGRASS AVE, SUITE 103
LOUISVILLE, KY 40215
Jefferson County (502) 367-4500
MRS. CATHY ELIZABETH COLLIER APRN
Nurse Practitioner
1900 BLUEGRASS AVE, SUITE 103
LOUISVILLE, KY 40215
Jefferson County (502) 367-4500
ERIN EICHENBERGER APRN-C, FNP
Nurse Practitioner (Family)
1900 BLUEGRASS AVE
LOUISVILLE, KY 40215
Jefferson County (502) 367-4500
ARUN UMMAT M.D.
Internal Medicine (Interventional Cardiology)
1900 BLUEGRASS AVE, SUITE 103
LOUISVILLE, KY 40215
Jefferson County (502) 367-4500
LORI ANNE ROGERS ARNP
Nurse Practitioner
1900 BLUEGRASS AVE, SUITE 103
LOUISVILLE, KY 40215
Jefferson County (502) 367-4500
BLUEGRASS CARDIOLOGY ASSOCIATES PLLC
Nurse Practitioner
1900 BLUEGRASS AVE, SUITE 103
LOUISVILLE, KY 40215
Jefferson County (502) 367-4500
GRIFFIN KNEPP DNP, APRN, FNP-C
Nurse Practitioner (Family)
1900 BLUEGRASS AVE
LOUISVILLE, KY 40215
Jefferson County (502) 367-4500
SUNNY ABRAHAM JOSEPH M.D.
Internal Medicine (Cardiovascular Disease)
1900 BLUEGRASS AVE, SUITE 103
LOUISVILLE, KY 40215
Jefferson County (502) 367-4500

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 Lal Tanwani's NPI number?

The NPI number for Lal Tanwani is 1336133347. It was assigned to this individual provider in the NPPES registry on September 6, 2005.

Where is Lal Tanwani located?

Lal Tanwani practices at 1900 Bluegrass Ave Suite 108, Louisville, KY 40215. The listed phone number is (502) 361-2524.

What is Lal Tanwani's specialty?

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

Is Lal Tanwani enrolled in Medicare?

Yes. Lal Tanwani 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 Lal Tanwani accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield and 1 other insurer list Lal Tanwani 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 Lal Tanwani affiliated with any hospitals?

According to CMS data, Lal Tanwani is affiliated with Jewish Hospital & St Mary's Healthcare and University Of Louisville Hospital.

When was this NPI record last updated?

The NPPES record for Lal Tanwani was last updated on May 23, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.