DR. DINESH MADHOK M.D.
NPI 1366434409
Internal Medicine - Gastroenterology in Orange Park, FL

Q: What is Dinesh Madhok's NPI number?

The NPI number for Dinesh Madhok is 1366434409. It was assigned to this individual provider in the NPPES registry on August 16, 2005.

Q: What is Dinesh Madhok's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Dinesh Madhok was last updated on May 24, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since August 16, 2005PECOS EnrolledAccepts Medicare Assignment

77.15/100

CMS Quality Rating

1883 KINGSLEY AVE, STE 1100, ORANGE PARK, FL 32073(904) 264-9797(904) 264-4644 Get Directions Write a Review

NPPES record last updated: May 24, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Dinesh Madhok M.d. NPPES

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

DR. DINESH MADHOK M.D. (NPI 1366434409) is an individual gastroenterology provider in Orange Park, Florida, licensed in Florida (ME63301) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Ascension St Vincent's Riverside, and is a graduate of Other (1984).

NPPES Registry Identity

NPI1366434409

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameDR. DINESH MADHOKCredential: M.D.

Location Address1883 KINGSLEY AVE, STE 1100Orange Park, FL 32073-4479

Mailing Address4800 Belfort RdJacksonville, FL 32256-6004 · (904) 398-3262 · Fax (904) 265-4807

Phone(904) 264-9797

Fax(904) 264-4644

Sole ProprietorNo

Medical School CMSOtherGraduated 1984

Enumeration DateAugust 16, 2005

Last NPPES UpdateMay 24, 2011

✔ NPI 1366434409 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in FL · ME63301

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.

1883 KINGSLEY AVE, Orange Park, FL 32073

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Other Identifiers 3

Medicare UPINF66246FL

Medicaid373081600FL

Medicare PIN18945YFL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, AvMed 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

Dr. Dinesh Madhok 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 ID446282859

PECOS Enrollment IDI20101206001050

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 15

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 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.

630 services450 patients

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.

205 services191 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

143 services143 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

131 services131 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

131 services131 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

90 services89 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

66 services66 patients

Infusion, normal saline solution, 250 cc J7050

An infusion of normal saline solution, 250 cc, involves administering a sterile saltwater solution into your body through a vein, usually in your arm. This helps to replenish fluids, maintain hydration, and balance electrolytes in your body.

61 services19 patients

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

50 services50 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

36 services36 patients

Administration of chemotherapy into vein, 1 hour or less 96413

Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.

36 services18 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

36 services36 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.

24 services24 patients

Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm 43249

This procedure involves using a flexible tube with a camera, called an endoscope, to gently expand narrowed areas in your esophagus, stomach, or upper small bowel. A small balloon is inflated, making it easier for food and liquid to pass through. It's safe and effective.

21 services21 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

20 services20 patients

Hospital Affiliations CMS Care Compare 4

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

Ascension St Vincent's Riverside

Acute Care Hospitals · Jacksonville, FL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100040

Location1 Shircliff WayJacksonville, FL 32204 · Duval County

Emergency services

Baptist Health Medical Center - Jacksonville

Acute Care Hospitals · Jacksonville, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100088

Location800 Prudential DrJacksonville, FL 32207 · Duval County

Emergency services Birthing friendly

Hca Florida Orange Park Hospital

Acute Care Hospitals · Orange Park, FL

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number100226

Location2001 Kingsley AveOrange Park, FL 32073 · Clay County

Emergency services Birthing friendly

Ascension St Vincent's Clay County

Acute Care Hospitals · Middleburg, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100321

Location1670 St Vincents WayMiddleburg, FL 32068 · Clay County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32073 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

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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.

77.15/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

65.95

Promoting Interoperability

Improvement Activities

Cost

61.22

Reported Quality Measures

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

88%829 patients5/55-star benchmark: 85%

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.

97%1,874 patients4/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

92%2,085 patients4/55-star benchmark: 100%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

99%806 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

42%1,424 patients2/55-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

3%834 patients1/55-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…

4%1,333 patients1/55-star benchmark: 97%

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 screenedForUse: 36% · 416 patients

35%416 patients2/55-star benchmark: 98%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

95%1,424 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

54%1,424 patients3/55-star benchmark: 79%

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.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ORANGE PARK MEDICAL CENTER, INC.

Rehabilitation Unit

1883 KINGSLEY AVE
ORANGE PARK, FL 32073

Clay County (904) 639-8500

ANNE TERESA HESSON REESER ARNP

Nurse Practitioner

1883 KINGSLEY AVE, SUITE 1100
ORANGE PARK, FL 32073

Clay County (904) 264-9797

DR. JAMES R KIMBERLY JR. M.D.

Internal Medicine (Gastroenterology)

1883 KINGSLEY AVE, STE 1100
ORANGE PARK, FL 32073

Clay County (904) 264-9797

DR. ABHIJIT ROYCHOWDHURY MD

Internal Medicine (Gastroenterology)

1883 KINGSLEY AVE, STE 1100
ORANGE PARK, FL 32073

Clay County (904) 264-9797

KATHERINE GRACE TUVERSON MOT, OTR/L

Occupational Therapist

1883 KINGSLEY AVE
ORANGE PARK, FL 32073

Clay County (904) 639-1800

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 Dinesh Madhok's NPI number?

The NPI number for Dinesh Madhok is 1366434409. It was assigned to this individual provider in the NPPES registry on August 16, 2005.

Where is Dinesh Madhok located?

Dinesh Madhok practices at 1883 Kingsley Ave Ste 1100, Orange Park, FL 32073. The listed phone number is (904) 264-9797.

What is Dinesh Madhok's specialty?

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

Is Dinesh Madhok enrolled in Medicare?

Yes. Dinesh Madhok 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 Dinesh Madhok accept?

Health plans from Ambetter Health, Ambetter of Alabama, AvMed, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 2 other insurers list Dinesh Madhok 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 Dinesh Madhok affiliated with any hospitals?

According to CMS data, Dinesh Madhok is affiliated with Ascension St Vincent's Riverside, Baptist Health Medical Center - Jacksonville, Hca Florida Orange Park Hospital and Ascension St Vincent's Clay County.

When was this NPI record last updated?

The NPPES record for Dinesh Madhok was last updated on May 24, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.