MR. SUSHILKUMAR MAHABIRPRASAD TIBREWALA M.D.
NPI 1457366858
Internal Medicine - Gastroenterology in Herrin, IL

Q: What is Sushilkumar Tibrewala's NPI number?

The NPI number for Sushilkumar Tibrewala is 1457366858. It was assigned to this individual provider in the NPPES registry on July 31, 2006. The provider is also known as Sushil Tibrewala M.D..

Q: What is Sushilkumar Tibrewala's specialty?

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

Active since July 31, 2006PECOS EnrolledAccepts Medicare Assignment

76.08/100

CMS Quality Rating

3301 PATRIOT CT, HERRIN, IL 62948(618) 998-8885(618) 998-8886 Get Directions Write a Review

NPPES record last updated: September 11, 2018. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Mr. Sushilkumar Mahabirprasad Tibrewala M.d. NPPES

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

MR. SUSHILKUMAR MAHABIRPRASAD TIBREWALA M.D. (NPI 1457366858) is an individual gastroenterology provider in Herrin, Illinois, licensed in Illinois (036-073571) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Herrin Hospital, and is a graduate of Other (1977).

NPPES Registry Identity

NPI1457366858

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameMR. SUSHILKUMAR MAHABIRPRASAD TIBREWALACredential: M.D.

Location Address3301 PATRIOT CTHerrin, IL 62948-3782

Mailing Address24 Pine Lake DrCarbondale, IL 62901-5410 · (618) 998-8885 · Fax (618) 998-8886

Phone(618) 998-8885

Fax(618) 998-8886

Sole ProprietorNo

Medical School CMSOtherGraduated 1977

Enumeration DateJuly 31, 2006

Last NPPES UpdateSeptember 11, 2018

✔ NPI 1457366858 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 IL · 036-073571

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.

3301 PATRIOT CT, Herrin, IL 62948

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Other Names 1

Other Name (5)Sushil Tibrewala M.d.

Other Identifiers 3

Other0010023397IL · Blue Cross/blue Shield

Other833199720IL · Aetna

Medicaid036073571IL

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

Mr. Sushilkumar Mahabirprasad Tibrewala 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 ID749187276

PECOS Enrollment IDI20031215000163

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 12

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.

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.

265 services263 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.

181 services178 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

143 services141 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.

142 services116 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.

48 services48 patients

Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare 43251

This procedure involves the use of a thin, flexible instrument called an endoscope to visualize and remove abnormal growths, known as polyps, from the esophagus, stomach, or upper small bowel. A tool called a mechanical snare is used to safely cut and remove these growths.

44 services44 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.

37 services37 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.

35 services33 patients

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.

31 services31 patients

Injection beneath lining of large bowel using a flexible endoscope 45381

This procedure involves a flexible tube, called an endoscope, being inserted into the large bowel. A small needle is then passed through the tube to inject medication under the bowel lining. This is typically done to treat inflammation or bleeding.

30 services29 patients

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

21 services21 patients

Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery 45384

This procedure involves using a flexible tube with a camera, called an endoscope, to view the large intestine. If any abnormal growths or polyps are found, they are removed with an electrically-heated instrument. This is a common way to prevent bowel issues.

20 services19 patients

Hospital Affiliations CMS Care Compare 5

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

Herrin Hospital

Acute Care Hospitals · Herrin, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140011

Location201 S 14th StHerrin, IL 62948 · Williamson County

Emergency services

Memorial Hospital Of Carbondale

Acute Care Hospitals · Carbondale, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140164

Location405 W JacksonCarbondale, IL 62901 · Jackson County

Emergency services Birthing friendly

Heartland Regional Medical Center

Acute Care Hospitals · Marion, IL

2/5 CMS rating

OwnershipProprietary

CMS Certification Number140184

Location3333 W DeyoungMarion, IL 62959 · Williamson County

Emergency services

Harrisburg Medical Center

Acute Care Hospitals · Harrisburg, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140210

Location100 Doctor Warren Tuttle DrHarrisburg, IL 62946 · Saline County

Emergency services

St Joseph Memorial Hospital

Critical Access Hospitals · Murphysboro, IL

OwnershipVoluntary non-profit - Private

CMS Certification Number141334

Location2 South Hospital DriveMurphysboro, IL 62966 · Jackson County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62948 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

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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.

76.08/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

65.4

Improvement Activities

Cost

58.19

Reported Quality Measures

Age Appropriate Screening Colonoscopy

Lower rates are better for this measure.

100%1,620 patients

Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk Patients

16%391 patients

Colonoscopy Interval for Patients with a History of Adenomatous Polyps - Avoidance of Inappropriate Use

67%694 patients

Colorectal Cancer Screening

99%546 patients4/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

47%836 patients1/55-star benchmark: 100%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

15%885 patients1/55-star benchmark: 100%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 97% · 237 patients

Patients screened: 97% · 237 patients

80%35 patients4/55-star benchmark: 100%

Tobacco Use and Help with Quitting Among Adolescents

91%35 patients3/55-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

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

GASTROENTEROLOGY CARE OF SOUTHERN ILLINOIS, LLC

Internal Medicine (Gastroenterology)

3301 PATRIOT CT
HERRIN, IL 62948

Williamson County (618) 998-8885

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 Sushilkumar Tibrewala's NPI number?

The NPI number for Sushilkumar Tibrewala is 1457366858. It was assigned to this individual provider in the NPPES registry on July 31, 2006. The provider is also known as Sushil Tibrewala M.D..

Where is Sushilkumar Tibrewala located?

Sushilkumar Tibrewala practices at 3301 Patriot Ct, Herrin, IL 62948. The listed phone number is (618) 998-8885.

What is Sushilkumar Tibrewala's specialty?

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

Is Sushilkumar Tibrewala enrolled in Medicare?

Yes. Sushilkumar Tibrewala 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.

Is Sushilkumar Tibrewala affiliated with any hospitals?

According to CMS data, Sushilkumar Tibrewala is affiliated with Herrin Hospital, Memorial Hospital Of Carbondale, Heartland Regional Medical Center, Harrisburg Medical Center and St Joseph Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Sushilkumar Tibrewala was last updated on September 11, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.