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SUBARNA MANI DHITAL MD
NPI 1356518047
Internal Medicine - Endocrinology, Diabetes & Metabolism in Madison, WI

Active since May 12, 2008PECOS EnrolledAccepts Medicare Assignment
451 JUNCTION RD, MADISON, WI 53717(608) 263-5010(608) 833-6935 Get Directions Write a Review

NPPES record last updated: February 2, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 2, 2021, Jun 15, 2017 (2 updates tracked since 2017).

About Subarna Mani Dhital Md NPPES

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

SUBARNA MANI DHITAL MD (NPI 1356518047) is an individual endocrinology, diabetes & metabolism provider in Madison, Wisconsin, licensed in Wisconsin (54518) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS, is affiliated with Unitypoint Health - Meriter, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1356518047
Entity TypeIndividualMale
Primary Taxonomy207RE0101X
Provider Legal NameSUBARNA MANI DHITALCredential: MD
Location Address451 JUNCTION RDMadison, WI 53717-2656
Mailing Address451 Junction RdMadison, WI 53717-2656 · (608) 263-5010
Phone(608) 263-5010
Fax(608) 833-6935
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateMay 12, 2008
Last NPPES UpdateFebruary 2, 20212 updates tracked since enumeration
NPPES CertifiedFebruary 2, 2021
✔ NPI 1356518047 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in WI · 54518
Definition

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.

451 JUNCTION RD, Madison, WI 53717
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Other Identifiers 1

Medicaid1356518047WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Group Health Cooperative-SCW 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

Subarna Mani Dhital 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 ID2860547692
PECOS Enrollment IDI20160615000002
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 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.

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.
310 services291 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
105 services74 patients
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.
56 services27 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.
53 services37 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.
32 services32 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
22 services22 patients

Hospital Affiliations CMS Care Compare 4

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

Unitypoint Health - Meriter

Acute Care Hospitals · Madison, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520089
Location202 S Park StMadison, WI 53715 · Dane County
Emergency services Birthing friendly

Sauk Prairie Hospital

Acute Care Hospitals · Prairie Du Sac, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520095
Location260 26th StreetPrairie Du Sac, WI 53578 · Sauk County
Emergency services Birthing friendly

University Of Wi Hospitals & Clinics Authority

Acute Care Hospitals · Madison, WI
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number520098
Location600 Highland AvenueMadison, WI 53792 · Dane County
Emergency services

Reedsburg Area Medical Center

Critical Access Hospitals · Reedsburg, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number521351
Location2000 N Dewey AveReedsburg, WI 53959 · Sauk County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53717 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

Referred Medical Equipment & Supplies CMS DME claims 5

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
5 suppliers31 claims380 services$18.08 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
5 suppliers32 claims1,025 services$2.30 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
20 suppliers50 claims283 services$6.27 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
8 suppliers15 claims42 services$1.10 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
16 suppliers254 claims259 services$185.13 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.

MRS. TERESA LYNN WOLFE PA
Physician Assistant (Medical)
451 JUNCTION RD
MADISON, WI 53717
Dane County (608) 265-7670
DR. MARIAH A. QUINN M.D.
Internal Medicine
451 JUNCTION RD
MADISON, WI 53717
Dane County (608) 265-7550
DR. YEW-XIN TEH MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
451 JUNCTION RD
MADISON, WI 53717
Dane County (608) 263-5010
ABIGAIL M BALES MD
Internal Medicine
451 JUNCTION RD
MADISON, WI 53717
Dane County (608) 265-1600
UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY
Pharmacy
451 JUNCTION RD, SUITE 9901, ROOM 1191
MADISON, WI 53717
Dane County (608) 265-7070
ANNA HABERMEYER CNM
Nurse Practitioner
451 JUNCTION RD
MADISON, WI 53717
Dane County (608) 265-7601
MRS. SHERRY XIONG NP
Nurse Practitioner
451 JUNCTION RD
MADISON, WI 53717
Dane County (608) 263-7577
DANIELA C CONSTANTINESCU MD
Internal Medicine
451 JUNCTION RD
MADISON, WI 53717
Dane County (608) 265-7550

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 Subarna Dhital's NPI number?

The NPI number for Subarna Dhital is 1356518047. It was assigned to this individual provider in the NPPES registry on May 12, 2008.

Where is Subarna Dhital located?

Subarna Dhital practices at 451 Junction Rd, Madison, WI 53717. The listed phone number is (608) 263-5010.

What is Subarna Dhital's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Subarna Dhital enrolled in Medicare?

Yes. Subarna Dhital 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 Subarna Dhital accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Group Health Cooperative-SCW, HealthPartners and Quartz and 1 other insurer list Subarna Dhital 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 Subarna Dhital affiliated with any hospitals?

According to CMS data, Subarna Dhital is affiliated with Unitypoint Health - Meriter, Sauk Prairie Hospital, University Of Wi Hospitals & Clinics Authority and Reedsburg Area Medical Center.

When was this NPI record last updated?

The NPPES record for Subarna Dhital was last updated on February 2, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.