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JOHN THOMAS SWEENEY MD
NPI 1427162320
Internal Medicine - Gastroenterology in Winston Salem, NC

Active since August 18, 2006PECOS EnrolledAccepts Medicare Assignment
87.61/100
CMS Quality Rating
1901 S HAWTHORNE RD, SUITE 310, WINSTON SALEM, NC 27103(336) 448-2427(336) 765-2869 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Nov 3, 2020, Jan 19, 2016 (2 updates tracked since 2016).

About John Thomas Sweeney Md NPPES

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

JOHN THOMAS SWEENEY MD (NPI 1427162320) is an individual gastroenterology provider in Winston Salem, North Carolina, licensed in North Carolina (9701612) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Northern Regional Hospital, and is a graduate of Jc Edwards School Of Medicine, Marshall University (1995).

NPPES Registry Identity

NPI1427162320
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameJOHN THOMAS SWEENEYCredential: MD
Location Address1901 S HAWTHORNE RD, SUITE 310Winston Salem, NC 27103-3921
Mailing Address1830 S Hawthorne RoadWinston Salem, NC 27103-4047 · (336) 448-2427 · Fax (336) 765-2869
Phone(336) 448-2427
Fax(336) 765-2869
Sole ProprietorNo
Medical School CMSJc Edwards School Of Medicine, Marshall UniversityGraduated 1995
Enumeration DateAugust 18, 2006
Last NPPES UpdateNovember 27, 20232 updates tracked since enumeration
NPPES CertifiedNovember 3, 2020
✔ NPI 1427162320 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 NC · 9701612
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.
1901 S HAWTHORNE RD, Winston Salem, NC 27103
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Other Identifiers 2

Medicaid89-13272NC
Other13272Blue Cross Blue Shield Nc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, UnitedHealthcare.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

John Thomas Sweeney Md 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 ID2365481017
PECOS Enrollment IDI20050502000836
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 11

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 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.
120 services90 patients
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.
108 services87 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.
85 services84 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.
70 services65 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.
67 services67 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.
34 services34 patients

Hospital Affiliations CMS Care Compare 2

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

Northern Regional Hospital

Acute Care Hospitals · Mount Airy, NC
5/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340003
Location830 Rockford StMount Airy, NC 27030 · Surry County
Emergency services Birthing friendly

Novant Health Forsyth Medical Center

Acute Care Hospitals · Winston-Salem, NC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340014
Location3333 Silas Creek ParkwayWinston-Salem, NC 27103 · Forsyth County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27103 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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.

87.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.26
Promoting Interoperability100
Improvement Activities40
Cost79.43

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
94%105 patients4/55-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
57%155 patients3/55-star benchmark: 100%
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…
49%174 patients2/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
44%80 patients2/55-star benchmark: 98%
Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older
Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months
6%102 patients1/55-star benchmark: 100%
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 16

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

PIEDMONT ENDOSCOPY CENTER, INC.
Clinic/Center (Ambulatory Surgical)
1901 S HAWTHORNE RD, SUITE 308
WINSTON-SALEM, NC 27103
Forsyth County (336) 760-4340
GASTROENTEROLOGY ASSOCIATES OF THE PIEDMONT, P.A.
Anesthesiology
1901 S HAWTHORNE RD, SUITE 308
WINSTON SALEM, NC 27103
Forsyth County (336) 448-2427
PIEDMONT GASTROENTEROLOGY SPECIALISTS, PA
Internal Medicine (Gastroenterology)
1901 S HAWTHORNE RD, SUITE 310
WINSTON SALEM, NC 27103
Forsyth County (336) 760-4340
BRIAN S SMITH MD
Internal Medicine (Gastroenterology)
1901 S HAWTHORNE RD, SUITE 310
WINSTON SALEM, NC 27103
Forsyth County (336) 448-2427
DR. RYAN LEE MCKIMMIE MD
Internal Medicine (Gastroenterology)
1901 S HAWTHORNE RD, SUITE 310
WINSTON SALEM, NC 27103
Forsyth County (336) 448-2427
MR. THOMAS R LITTLEJOHN ATC
Specialist/Technologist (Athletic Trainer)
1901 S HAWTHORNE RD
WINSTON SALEM, NC 27103
Forsyth County (336) 714-2619
WHAP PA
Obstetrics & Gynecology (Gynecology)
1901 S HAWTHORNE RD, STE 320
WINSTON SALEM, NC 27103
Forsyth County (336) 768-1180
FORSYTH MEMORIAL HOSPITAL INC
Internal Medicine (Infectious Disease)
1901 S HAWTHORNE RD, SUITE 220
WINSTON SALEM, NC 27103
Forsyth County (336) 718-6777

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 John Sweeney's NPI number?

The NPI number for John Sweeney is 1427162320. It was assigned to this individual provider in the NPPES registry on August 18, 2006.

Where is John Sweeney located?

John Sweeney practices at 1901 S Hawthorne Rd Suite 310, Winston Salem, NC 27103. The listed phone number is (336) 448-2427.

What is John Sweeney's specialty?

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

Is John Sweeney enrolled in Medicare?

Yes. John Sweeney 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 John Sweeney accept?

Health plans from Blue Cross and Blue Shield of NC and UnitedHealthcare list John Sweeney 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 John Sweeney affiliated with any hospitals?

According to CMS data, John Sweeney is affiliated with Northern Regional Hospital and Novant Health Forsyth Medical Center.

When was this NPI record last updated?

The NPPES record for John Sweeney was last updated on November 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.