AYUSH SUTARIA M.D.
NPI 1396199352
Internal Medicine in Houston, TX
NPI Status: Active since April 15, 2016
Contact Information
1 BAYLOR PLZ
RM 022D
HOUSTON, TX
ZIP 77030
Phone: (713) 798-5588
- Individual
- Male
- Years of Experience 10
- Internal Medicine
- Accepts Insurance
- May Accept Medicare Approved Payment
- PECOS Enrolled
About AYUSH SUTARIA
This page provides the complete NPI Profile along with additional information for Ayush Sutaria, an internist established in Houston, Texas with a medical specialization in Internal Medicine and more than 10 years of experience. The healthcare provider is registered in the NPI registry with number 1396199352 assigned on April 2016. The practitioner's primary taxonomy code is 207R00000X with license number 649403 (TX). The provider is registered as an individual and his NPI record was last updated 10 years ago.
- NPI
- 1396199352
- Provider Name
- AYUSH SUTARIA M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1 BAYLOR PLZ RM 022D HOUSTON, TX 77030
- Location Phone
- (713) 798-5588
- Mailing Address
- 1 BAYLOR PLZ RM 022D HOUSTON, TX 77030
- Medical School Name
- OTHER
- Graduation Year
- 2016
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-15-2016
- Last Update Date
- 04-15-2016
- Code Navigator
An internist like Ayush Sutaria 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
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 649403
- License State
- TX
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- Blue Advantage Plus Gold? 803 - POS
- Blue Advantage Plus Gold? Standard - POS
- Blue Advantage Plus Silver? 202 - POS
- Blue Advantage Plus Silver? 605 - POS
- Blue Advantage Plus Silver? Standard - POS
- Blue Advantage Security HMO? 200 - HMO
- Blue Advantage Silver HMO? 205 - HMO
- Blue Advantage Silver HMO? 801 - HMO
- Blue Advantage Silver HMO? Standard - HMO
- MyBlue Health Bronze? 402 - HMO
- Community Premier Bronze 003 (No deductible for PCP, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Premier Bronze 018 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Premier Gold 005 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Premier Gold 021 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Premier Silver 012 (No deductible for PCP, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Premier Silver 020 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Select Bronze 016 (No deductible for PCP, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Select Gold 022 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Select Silver 019 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Ayush Sutaria is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
Ayush Sutaria 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
PECOS PAC ID: 6103154604
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20230822001021
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Maybe
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.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
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 77030 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $134.06
- Minimum New Patient Price $58.24
- Maximum New Patient Price $176.98
- Average New Patient Copayment $33.51
- Minimum New Patient Copayment $14.56
- Maximum New Patient Copayment $44.24
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $102.71
- Minimum Established Patient Price $18.6
- Maximum Established Patient Price $143.93
- Average Established Patient Copayment $25.67
- Minimum Established Patient Copayment $4.65
- Maximum Established Patient Copayment $35.98
* 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.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Ayush Sutaria is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| MONTEFIORE MEDICAL CENTER | 111 EAST 210TH STREET BRONX, NY 10467 | (718) 920-4321 | Acute Care Hospitals |
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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 1396199352, we treat the final digit (2) 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 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).
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 68 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
HOUSTON, TX 77030
HOUSTON, TX 77030
HOUSTON, TX 77030
HOUSTON, TX 77030
HOUSTON, TX 77030
HOUSTON, TX 77030
HOUSTON, TX 77030
HOUSTON, TX 77030
HOUSTON, TX 77030
HOUSTON, TX 77030
HOUSTON, TX 77030
HOUSTON, TX 77030
HOUSTON, TX 77030
HOUSTON, TX 77030
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1396199352, enumerated as an "individual" on April 15, 2016.
The provider is located at 1 BAYLOR PLZ RM 022D HOUSTON, TX 77030 and the phone number is (713) 798-5588.
Internal Medicine with taxonomy code 207R00000X.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas and Community. Please consult your insurance carrier or call the provider to verify.
Ayush Sutaria is affiliated with: MONTEFIORE MEDICAL CENTER.
