DR. PRITESH R MUTHA M.D., DIPABLM, MPH
NPI 1386871598
Internal Medicine - Gastroenterology in Houston, TX

Active since June 15, 2009PECOS EnrolledAccepts Medicare Assignment
82.38/100
CMS Quality Rating
6400 FANNIN ST STE 1400, HOUSTON, TX 77030(713) 704-3450(713) 704-9938 Get Directions Write a Review

NPPES record last updated: September 30, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 30, 2022, Mar 7, 2022 (2 updates tracked since 2022).

About Dr. Pritesh R Mutha M.d., Dipablm, Mph NPPES

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

DR. PRITESH R MUTHA M.D., DIPABLM, MPH (NPI 1386871598) is an individual gastroenterology provider in Houston, Texas, licensed in Texas (T3831) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS, is affiliated with Memorial Hermann - Texas Medical Center, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1386871598
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. PRITESH R MUTHACredential: M.D., DIPABLM, MPH
Location Address6400 FANNIN ST STE 1400Houston, TX 77030-1512
Mailing Address6400 Fannin St Ste 1400Houston, TX 77030-1512 · (713) 704-3450 · Fax (713) 704-9938
Fax(713) 704-9938
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateJune 15, 2009
Last NPPES UpdateSeptember 30, 20222 updates tracked since enumeration
NPPES CertifiedSeptember 30, 2022
NPI 1386871598 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Licenses Licensed in TX · T3831 Licensed in VA · 0101257552
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 MedicineTaxonomy 207R00000X · License MT194941 (PA)
6400 FANNIN ST STE 1400, Houston, TX 77030

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

Dr. Pritesh R Mutha M.d., Dipablm, Mph 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 ID5698917573
PECOS Enrollment IDI20220513000924
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 17

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.

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.
50 services50 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.
48 services35 patients
Exam of common bile and/or pancreatic duct using a flexible endoscope 43273
This procedure, known as an ERCP, involves a flexible tube with a camera, called an endoscope, being gently passed down your throat to examine your common bile or pancreatic duct. It helps doctors diagnose and treat conditions affecting these areas.
38 services22 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.
34 services33 patients
Removal of stone or debris from bile or pancreatic duct using a flexible endoscope 43264
This procedure, called an endoscopic retrograde cholangiopancreatography (ERCP), involves using a flexible tube with a camera (endoscope) to locate and remove stones or debris from your bile or pancreatic duct. It's a non-surgical method to clear the ducts, enhancing your digestive health.
32 services21 patients
Review by radiologist of image from tube placement into bile duct using an endoscope 74328
This procedure involves a specialist, called a radiologist, examining an image taken during a tube placement into your bile duct. The tube is inserted with the help of a tool called an endoscope. This allows the doctor to check for any issues or abnormalities in your bile duct.
25 services17 patients

Hospital Affiliations CMS Care Compare 2

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

Memorial Hermann - Texas Medical Center

Acute Care Hospitals · Houston, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450068
Location6411 FanninHouston, TX 77030 · Harris County
Emergency services Birthing friendly

Memorial Hermann Katy Hospital

Acute Care Hospitals · Katy, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450847
Location23900 Katy FreewayKaty, TX 77494 · Fort Bend County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77030 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
$134.06 typical visit price
range $58.24 – $176.98
Typical copayment $33.51 (range $14.56 – $44.24)
Most-billed visit code 99204
Established Patient
$102.71 typical visit price
range $18.60 – $143.93
Typical copayment $25.67 (range $4.65 – $35.98)
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.

82.38/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.23
Promoting Interoperability100
Improvement Activities40
Cost58.5

Other Providers at the Same Location NPPES 14

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

Internal Medicine (Gastroenterology)
6400 FANNIN ST STE 1400
HOUSTON, TX 77030
Internal Medicine (Gastroenterology)
6400 FANNIN ST STE 1400
HOUSTON, TX 77030
Internal Medicine (Gastroenterology)
6400 FANNIN ST STE 1400
HOUSTON, TX 77030
Internal Medicine (Gastroenterology)
6400 FANNIN ST STE 1400
HOUSTON, TX 77030
Internal Medicine (Gastroenterology)
6400 FANNIN ST STE 1400
HOUSTON, TX 77030
Internal Medicine (Gastroenterology)
6400 FANNIN ST STE 1400
HOUSTON, TX 77030
Internal Medicine (Gastroenterology)
6400 FANNIN ST STE 1400
HOUSTON, TX 77030
Internal Medicine (Gastroenterology)
6400 FANNIN ST STE 1400
HOUSTON, TX 77030

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 Pritesh Mutha's NPI number?

The NPI number for Pritesh Mutha is 1386871598. It was assigned to this individual provider in the NPPES registry on June 15, 2009.

Where is Pritesh Mutha located?

Pritesh Mutha practices at 6400 Fannin St Ste 1400, Houston, TX 77030. The listed phone number is (713) 704-3450.

What is Pritesh Mutha's specialty?

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

Is Pritesh Mutha enrolled in Medicare?

Yes. Pritesh Mutha 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 Pritesh Mutha accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 5 other insurers list Pritesh Mutha 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 Pritesh Mutha affiliated with any hospitals?

According to CMS data, Pritesh Mutha is affiliated with Memorial Hermann - Texas Medical Center and Memorial Hermann Katy Hospital.

When was this NPI record last updated?

The NPPES record for Pritesh Mutha was last updated on September 30, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.