SURESH KARNE MD PHD
NPI 1366534307
Internal Medicine - Gastroenterology in Huntsville, AL

Active since September 28, 2006PECOS EnrolledAccepts Medicare Assignment
84.33/100
CMS Quality Rating
420 LOWELL DRIVE, SUITE 204, HUNTSVILLE, AL 35801(256) 536-9031(256) 539-4240 Get Directions Write a Review

NPPES record last updated: February 7, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Suresh Karne Md Phd NPPES

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

SURESH KARNE MD PHD (NPI 1366534307) is an individual gastroenterology provider in Huntsville, Alabama, licensed in Alabama (23431) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS and is a graduate of Yale University School Of Medicine (1995).

NPPES Registry Identity

NPI1366534307
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameSURESH KARNECredential: MD PHD
Location Address420 LOWELL DRIVE, SUITE 204Huntsville, AL 35801-3763
Mailing Address420 Lowell Drive, Suite 204Huntsville, AL 35801-3763 · (256) 536-9031 · Fax (256) 539-4240
Fax(256) 539-4240
Sole ProprietorNo
Medical School CMSYale University School Of MedicineGraduated 1995
Enumeration DateSeptember 28, 2006
Last NPPES UpdateFebruary 7, 2012
NPI 1366534307 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License Licensed in AL · 23431
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.
Also ListedInternal Medicine · HepatologyTaxonomy 207RI0008X · License 23431 (AL)
420 LOWELL DRIVE, Huntsville, AL 35801

Other Identifiers 4

OtherE324AL · Medicare Group Payer #
Medicaid000097266AL
Other000097266AL · Medicare Individual Provi
Medicare UPING71466AL

Accepted 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

Suresh Karne Md Phd 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 ID5496947707
PECOS Enrollment IDI20101005000916
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 27

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.
241 services198 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.
176 services123 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
155 services103 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.
135 services135 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.
114 services94 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.
111 services111 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35801 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
$122.31 typical visit price
range $52.65 – $161.63
Typical copayment $30.57 (range $13.16 – $40.40)
Most-billed visit code 99204
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
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.

84.33/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality76.96
Improvement Activities40

Reported Quality Measures

Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk Patients
Percentage of patients aged 50 to 75 years of age receiving a screening colonoscopy without biopsy or polypectomy who had a recommended follow-up interval of at least 10 years for repeat colonoscopy documented in their colonoscopy report
85%304 patients
Appropriate indication for colonoscopy
Percentage of colonoscopy procedures performed for an indication that is included in a published standard list of appropriate indications and the indication is documented
85%1,339 patients3/55-star benchmark: 99%
Appropriate management of anticoagulation in the peri-procedural period rate - EGD
Percentage of patients undergoing an EGD on an anti-platelet agent or an anticoagulant who leave the endoscopy unit with instructions for management of this medication
18%106 patients1/55-star benchmark: 100%
NHCR4: Repeat screening or surveillance colonoscopy recommended within one year due to inadequate/poor bowel preparation
Percentage of patients recommended for repeat screening or surveillance colonoscopy within one year or less due to inadequate/poor bowel preparation quality
6%36 patients
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 2

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

Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034
Other-Enteral and Parenteral · category OB006N
2 suppliers39 claims981 services$3.31 avg. paid by Medicare
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152
Other-Enteral and Parenteral · category OB006N
1 supplier36 claims19,147 services$0.32 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 2

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

Internal Medicine (Gastroenterology)
420 LOWELL DRIVE, SUITE 204
HUNTSVILLE, AL 35801
General Acute Care Hospital (Children)
420 LOWELL DRIVE, SUITE 401
HUNTSVILLE, AL 35801

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 Suresh Karne's NPI number?

The NPI number for Suresh Karne is 1366534307. It was assigned to this individual provider in the NPPES registry on September 28, 2006.

Where is Suresh Karne located?

Suresh Karne practices at 420 Lowell Drive Suite 204, Huntsville, AL 35801. The listed phone number is (256) 536-9031.

What is Suresh Karne's specialty?

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

Is Suresh Karne enrolled in Medicare?

Yes. Suresh Karne 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 Suresh Karne accept?

Health plans from Ambetter Health, Ambetter from Magnolia Health, Ambetter of Alabama, Ambetter of Tennessee and Blue Cross and Blue Shield of Alabama and 3 other insurers list Suresh Karne 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.

When was this NPI record last updated?

The NPPES record for Suresh Karne was last updated on February 7, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.