SUDHIR BANSAL MD
NPI 1356373633
Internal Medicine - Endocrinology, Diabetes & Metabolism in Warwick, RI
NPI Status: Active since July 07, 2006
Contact Information
215 TOLLGATE ROAD
SUITE 309/310
WARWICK, RI
ZIP 02886
Phone: (401) 732-6828
Fax: (401) 223-3040
- Individual
- Male
- Internal Medicine
- Endocrinology, Diabetes & Metabolism
- PECOS Enrolled
- CLIA Number: 41D0083166
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-25-2027
About SUDHIR BANSAL
This page provides the complete NPI Profile along with additional information for Sudhir Bansal, an internist established in Warwick, Rhode Island with a medical specialization in Internal Medicine, focusing in endocrinology, diabetes & metabolism . The healthcare provider is registered in the NPI registry with number 1356373633 assigned on July 2006. The practitioner's primary taxonomy code is 207RE0101X with license number 7603 (RI). The provider is registered as an individual and his NPI record was last updated 19 years ago.
- NPI
- 1356373633
- Provider Name
- SUDHIR BANSAL MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 215 TOLLGATE ROAD SUITE 309/310 WARWICK, RI 02886
- Location Phone
- (401) 732-6828
- Location Fax
- (401) 223-3040
- Mailing Address
- 215 TOLLGATE ROAD SUITE 309/310 WARWICK, RI 02886
- Mailing Phone
- (401) 732-6828
- Mailing Fax
- (401) 223-3040
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-07-2006
- Last Update Date
- 07-08-2007
- Code Navigator
An internist like Sudhir Bansal is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Endocrinology, Diabetes & Metabolism
- Taxonomy Code
- 207RE0101X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 7603
- License State
- RI
- Taxonomy Description
- An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 119020098 | MEDICARE ID-TYPE UNSPECIFIED (04) | ||
| 050461074 | OTHER (01) | UHC | |
| 0000020098001 | OTHER (01) | BC | |
| 119020098 | OTHER (01) | MEDICARE PIN | |
| CPG002461001 | OTHER (01) | BLUE CHIP | |
| E30019 | MEDICARE UPIN (02) |
Medicare Participation & PECOS Enrollment Status
Sudhir Bansal is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
14 DME suppliers used 37 Medicare Claims 106 Services Paid
DME-Other DME (DE017N)
External ambulatory infusion pump, insulin (HCPCS:E0784)
2 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Other DME (DE017N)
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)
3 DME suppliers used 18 Medicare Claims 18 Services Paid
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 02886 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $134.17
- Minimum New Patient Price $58.57
- Maximum New Patient Price $177.03
- Average New Patient Copayment $33.54
- Minimum New Patient Copayment $14.64
- Maximum New Patient Copayment $44.25
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $103.1
- Minimum Established Patient Price $18.92
- Maximum Established Patient Price $144.38
- Average Established Patient Copayment $25.77
- Minimum Established Patient Copayment $4.73
- Maximum Established Patient Copayment $36.09
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 41D0083166
- Facility Type
- Physician Office
- Certificate Effective Date
- July 26, 2025
- Certificate Expiration Date
- July 25, 2027
- Laboratory Director
- SUDHIR BANSAL
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Sudhir Bansal to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1356373633, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 67 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1356373633, enumerated as an "individual" on July 07, 2006.
The provider is located at 215 TOLLGATE ROAD SUITE 309/310 WARWICK, RI 02886 and the phone number is (401) 732-6828.
Internal Medicine with taxonomy code 207RE0101X and a focus in Endocrinology, Diabetes & Metabolism.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
