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DR. NEIL K. SINHA M.D.
NPI 1427213826
Internal Medicine in Calhoun, GA

Active since July 24, 2008PECOS EnrolledAccepts Medicare Assignment
89.89/100
CMS Quality Rating
111A LAUREL CREEK RD SE, CALHOUN, GA 30701(706) 624-1001(706) 602-2784 Get Directions Write a Review

NPPES record last updated: February 11, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 11, 2025, Jul 21, 2022, Mar 17, 2018 and 2 more (5 updates tracked since 2016).

About Dr. Neil K. Sinha M.d. NPPES

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

DR. NEIL K. SINHA M.D. (NPI 1427213826) is an individual internal medicine provider in Calhoun, Georgia, licensed in Georgia (65183) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1427213826
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. NEIL K. SINHACredential: M.D.
Location Address111A LAUREL CREEK RD SECalhoun, GA 30701-7000
Mailing Address4300 N Point Pkwy Ste 300Alpharetta, GA 30022-4102
Phone(706) 624-1001
Fax(706) 602-2784
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateJuly 24, 2008
Last NPPES UpdateFebruary 11, 20255 updates tracked since enumeration
NPPES CertifiedFebruary 11, 2025
✔ NPI 1427213826 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in GA · 65183
Definition
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.
111A LAUREL CREEK RD SE, Calhoun, GA 30701
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Neil K. Sinha M.d. 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 ID749462778
PECOS Enrollment IDI20110311000102
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Neil Sinha reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Internal Medicine Associates Of Jasper, PC
28 mi
Internal Medicine
51 GORDON RD, SUITE 201
Jasper, GA 30143
  • Reassigned Medicare billing, Georgia enrollment
  • 19 clinicians in this Medicare group
NPI 1225109838 (706) 692-9768
Southeast Medical Group, P.C.
49 mi
Family Medicine
3905 BROOKSIDE PKWY STE 300
Alpharetta, GA 30022
  • Reassigned Medicare billing, Georgia enrollment
  • 240 clinicians in this Medicare group
NPI 1235296054 (770) 442-1911
Qcpi-Villagemd, PC
55 mi
Family Medicine
3445 PEACHTREE RD NE STE 1200
Atlanta, GA 30326
  • Reassigned Medicare billing, Georgia enrollment
  • 115 clinicians in this Medicare group
NPI 1558872432 (770) 822-6853

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30701 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

89.89/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality79.78
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
80%128 patients4/55-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…
100%264 patients5/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
100%263 patients5/55-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.

Referred Medical Equipment & Supplies CMS DME claims 3

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
10 suppliers32 claims92 services$6.08 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
6 suppliers12 claims14 services$1.09 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
4 suppliers29 claims29 services$192.17 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

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

PAMELA EVETTE HENSLEY NP
Nurse Practitioner (Family)
111A LAUREL CREEK RD SE
CALHOUN, GA 30701
Gordon County (706) 624-1001

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 Neil Sinha's NPI number?

The NPI number for Neil Sinha is 1427213826. It was assigned to this individual provider in the NPPES registry on July 24, 2008.

Where is Neil Sinha located?

Neil Sinha practices at 111A Laurel Creek Rd SE, Calhoun, GA 30701. The listed phone number is (706) 624-1001.

What is Neil Sinha's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Neil Sinha enrolled in Medicare?

Yes. Neil Sinha 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.

Which organizations bill Medicare for Neil Sinha's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Neil Sinha reassigns Medicare benefits to 3 organizations: Internal Medicine Associates Of Jasper, PC (Jasper, GA), Southeast Medical Group, P.C. (Alpharetta, GA) and Qcpi-Villagemd, PC (Atlanta, GA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Neil Sinha's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Neil Sinha accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Neil Sinha 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 Neil Sinha was last updated on February 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.