DR. MURTHY S MADHIRA M.D.
NPI 1477525913
Internal Medicine - Gastroenterology in Monroe, MI

Active since February 07, 2006PECOS EnrolledAccepts Medicare Assignment
1066 N MONROE ST, MONROE, MI 48162(734) 240-4870 Get Directions Write a Review

NPPES record last updated: November 3, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 3, 2023, Jan 18, 2017 (2 updates tracked since 2017).

About Dr. Murthy S Madhira M.d. NPPES

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

DR. MURTHY S MADHIRA M.D. (NPI 1477525913) is an individual gastroenterology provider in Monroe, Michigan, licensed in Michigan (4301064434) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Promedica Monroe Regional Hospital, and is a graduate of Other (1987).

NPPES Registry Identity

NPI1477525913
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. MURTHY S MADHIRACredential: M.D.
Location Address1066 N MONROE STMonroe, MI 48162-3113
Mailing Address1066 N Monroe StMonroe, MI 48162-3113 · (734) 240-4870
Sole ProprietorYes
Medical School CMSOtherGraduated 1987
Enumeration DateFebruary 7, 2006
Last NPPES UpdateNovember 3, 20232 updates tracked since enumeration
NPI 1477525913 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 MI · 4301064434
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.
1066 N MONROE ST, Monroe, MI 48162

Other Identifiers 1

Medicaid4477042MI

Accepted 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. Murthy S Madhira 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 ID2264328921
PECOS Enrollment IDI20040227000810, I20191218002497
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 14

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.
131 services102 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.
88 services88 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.
47 services47 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.
44 services41 patients
Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235
This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.
39 services37 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
36 services36 patients

Hospital Affiliations CMS Care Compare 2

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

Promedica Monroe Regional Hospital

Acute Care Hospitals · Monroe, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number230099
Location718 N Macomb StMonroe, MI 48162 · Monroe County
Emergency services Birthing friendly

Promedica Toledo Hospital

Acute Care Hospitals · Toledo, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360068
Location2142 North Cove BoulevardToledo, OH 43606 · Lucas County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48162 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
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

Reported Quality Measures

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%319 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.

Other Providers at the Same Location NPPES 8

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

Nurse Practitioner (Family)
1066 N MONROE ST
MONROE, MI 48162
Plastic Surgery
1066 N MONROE ST
MONROE, MI 48162
Nurse Practitioner (Family)
1066 N MONROE ST
MONROE, MI 48162
Nurse Practitioner
1066 N MONROE ST
MONROE, MI 48162
Internal Medicine (Gastroenterology)
1066 N MONROE ST
MONROE, MI 48162
Internal Medicine (Gastroenterology)
1066 N MONROE ST
MONROE, MI 48162
Registered Nurse
1066 N MONROE ST
MONROE, MI 48162
Nurse Practitioner (Family)
1066 N MONROE ST
MONROE, MI 48162

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 Murthy Madhira's NPI number?

The NPI number for Murthy Madhira is 1477525913. It was assigned to this individual provider in the NPPES registry on February 7, 2006.

Where is Murthy Madhira located?

Murthy Madhira practices at 1066 N Monroe St, Monroe, MI 48162. The listed phone number is (734) 240-4870.

What is Murthy Madhira's specialty?

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

Is Murthy Madhira enrolled in Medicare?

Yes. Murthy Madhira 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 Murthy Madhira accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, CareSource, McLaren Health Plan Community and Priority Health list Murthy Madhira 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 Murthy Madhira affiliated with any hospitals?

According to CMS data, Murthy Madhira is affiliated with Promedica Monroe Regional Hospital and Promedica Toledo Hospital.

When was this NPI record last updated?

The NPPES record for Murthy Madhira was last updated on November 3, 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.