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DR. DILPESH S AGRAWAL M.D, MRCP
NPI 1407134422
Internal Medicine - Gastroenterology in Milwaukee, WI

Active since July 25, 2011PECOS EnrolledAccepts Medicare Assignment
80.46/100
CMS Quality Rating
9200 W WISCONSIN AVE, DIVISION OF GASTROENTEROLOGY, MILWAUKEE, WI 53226(414) 955-6830(414) 955-6214 Get Directions Write a Review

NPPES record last updated: September 30, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Dilpesh S Agrawal M.d, Mrcp NPPES

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

DR. DILPESH S AGRAWAL M.D, MRCP (NPI 1407134422) is an individual gastroenterology provider in Milwaukee, Wisconsin, licensed in Wisconsin (61712) and active in the NPI registry since July 2011. He is enrolled in Medicare PECOS, is affiliated with Holy Family Memorial, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1407134422
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. DILPESH S AGRAWALCredential: M.D, MRCP
Location Address9200 W WISCONSIN AVE, DIVISION OF GASTROENTEROLOGYMilwaukee, WI 53226-3522
Mailing Address9200 W Wisconsin Ave, Division Of GastroenterologyMilwaukee, WI 53226-3522 · (414) 955-6830 · Fax (414) 955-6214
Phone(414) 955-6830
Fax(414) 955-6214
Sole ProprietorNo
Medical School CMSOtherGraduated 1998
Enumeration DateJuly 25, 2011
Last NPPES UpdateSeptember 30, 2019
✔ NPI 1407134422 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 WI · 61712
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.

9200 W WISCONSIN AVE, Milwaukee, WI 53226
Open in Google Maps ↗

Other Identifiers 1

Medicaid1407134422WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Network Health.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. Dilpesh S Agrawal M.d, Mrcp 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 ID9830314194
PECOS Enrollment IDI20140701000884
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 5

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 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.
40 services33 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.
31 services30 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.
30 services30 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.
22 services22 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.
14 services14 patients

Hospital Affiliations CMS Care Compare 2

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

Holy Family Memorial

Acute Care Hospitals · Manitowoc, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number520107
Location2300 Western AveManitowoc, WI 54221 · Manitowoc County
Emergency services

Froedtert Memorial Lutheran Hospital

Acute Care Hospitals · Milwaukee, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520177
Location9200 W Wisconsin AveMilwaukee, WI 53226 · Milwaukee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53226 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.

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.

80.46/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality66.24
Promoting Interoperability100
Improvement Activities40
Cost68.64

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.

TRACY BLAIR WANDTKE HERRMANN APNP, CNM
Advanced Practice Midwife
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-4777
DR. ZACHARY SMITH DO
Internal Medicine (Gastroenterology)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 955-6830
DR. COLLEEN ANN CROWE M.D., M.P.H.
Emergency Medicine
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6469
ROBERTO MEJIAS APNP
Nurse Practitioner (Pediatrics)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6600
MRS. ANNE E B LAKATOS APN-BC, APNP, RN
Nurse Practitioner (Adult Health)
9200 W WISCONSIN AVE, DEPT OF INTERNAL MEDICINE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6850
MRS. AMANDA M MANDERS APNP
Nurse Practitioner (Adult Health)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6850
KATHLEEN A WATERHOUSE-SKIBICKI CRNA
Nurse Anesthetist, Certified Registered
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-5951
ANDREA L BEQUEST PA
Physician Assistant (Medical)
9200 W WISCONSIN AVE, INTERNAL MEDICINE
MILWAUKEE, WI 53226
Milwaukee County (414) 955-0350

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 Dilpesh Agrawal's NPI number?

The NPI number for Dilpesh Agrawal is 1407134422. It was assigned to this individual provider in the NPPES registry on July 25, 2011.

Where is Dilpesh Agrawal located?

Dilpesh Agrawal practices at 9200 W Wisconsin Ave Division Of Gastroenterology, Milwaukee, WI 53226. The listed phone number is (414) 955-6830.

What is Dilpesh Agrawal's specialty?

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

Is Dilpesh Agrawal enrolled in Medicare?

Yes. Dilpesh Agrawal 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 Dilpesh Agrawal accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan and Network Health list Dilpesh Agrawal 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 Dilpesh Agrawal affiliated with any hospitals?

According to CMS data, Dilpesh Agrawal is affiliated with Holy Family Memorial and Froedtert Memorial Lutheran Hospital.

When was this NPI record last updated?

The NPPES record for Dilpesh Agrawal was last updated on September 30, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.