DR. SUJESH SATHYAN PILLAI MD
NPI 1497947071
Hospitalist in The Woodlands, TX
NPI Status: Active since August 16, 2007
Contact Information
17201 INTERSTATE 45 S
THE WOODLANDS, TX
ZIP 77385
Phone: (936) 270-2099
Fax: (713) 790-8703
- NPI Profile Information
- Primary Taxonomy
- Secondary Taxonomies
- Insurance Plans Accepted
- Medicare Participation & PECOS Status
- Areas of Expertise
- Durable Medical Equipment
- Physician Visit Costs
- Quality Reporting
- Hospital Affiliations - Privileges
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
- Individual
- Male
- Years of Experience 20
- Hospitalist
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About SUJESH PILLAI
This page provides the complete NPI Profile along with additional information for Sujesh Pillai, a provider established in The Woodlands, Texas with a medical specialization in Hospitalist and more than 20 years of experience. The healthcare provider is registered in the NPI registry with number 1497947071 assigned on August 2007. The practitioner's primary taxonomy code is 208M00000X with license number N4670 (TX). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1497947071
- Provider Name
- DR. SUJESH SATHYAN PILLAI MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 17201 INTERSTATE 45 S THE WOODLANDS, TX 77385
- Location Phone
- (936) 270-2099
- Location Fax
- (713) 790-8703
- Mailing Address
- 17201 INTERSTATE 45 S THE WOODLANDS, TX 77385
- Mailing Phone
- (936) 270-2099
- Mailing Fax
- (713) 790-8703
- Medical School Name
- OTHER
- Graduation Year
- 2006
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-16-2007
- Last Update Date
- 10-30-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Hospitalist
- Taxonomy Code
- 208M00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- N4670
- License State
- TX
- Taxonomy Description
- Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | N4670 (TX) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- Community Premier Gold 005 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Premier Gold 021 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Premier Silver 012 (No deductible for PCP, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Premier Silver 020 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Molina Gold Core 1640 - HMO
- Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
- Molina Gold Core 1640 Plus with Adult Vision - HMO
- Molina Gold Saver 750 - HMO
- Molina Gold Saver 750 Plus with Adult Dental and Vision - HMO
- Molina Gold Saver 750 Plus with Adult Vision - HMO
- Molina Gold Standard - HMO
- Molina Silver Core - HMO
- Molina Silver Core Plus with Adult Dental and Vision - HMO
- Molina Silver Core Plus with Adult Vision - HMO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits - EPO
- Bronze Simple Chronic Care CKM - EPO
- Bronze Simple Diabetes - EPO
- Gold Classic - EPO
- Gold Classic Standard - EPO
- Gold Elite - EPO
- Silver Classic - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1507741 | MEDICAID (05) | LA |
Medicare Participation & PECOS Enrollment Status
Sujesh Pillai is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Sujesh Pillai is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 8628265725
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20101214001112
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: No
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
2 DME suppliers used 50 Medicare Claims 50 Services Paid
DME-Oxygen and Supplies (DC002N)
Portable oxygen concentrator, rental (HCPCS:E1392)
1 DME suppliers used 38 Medicare Claims 38 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Hospital discharge day management, more than 30 minutes
Hospital observation care on day of discharge
Initial hospital inpatient care per day, typically 70 minutes
Initial hospital observation care per day, typically 70 minutes
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
This service was performed 179 times for 69 patientsFollow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
This service was performed 518 times for 210 patientsHospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
This service was performed 192 times for 180 patientsHospital observation care on the day of discharge involves monitoring your health status to ensure stability before you leave. This includes assessing vital signs, response to treatment, and readiness for home care or rehabilitation.
This service was performed 24 times for 23 patientsInitial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
This service was performed 63 times for 61 patientsThis service involves a healthcare professional closely monitoring your health condition during your hospital stay. It typically lasts for about 70 minutes each day. This helps in timely detection of any changes in your health, allowing for immediate response and treatment.
This service was performed 16 times for 16 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $31.6 for a new patient copayment and $24.26 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 77385 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $126.4
- Minimum New Patient Price $54.84
- Maximum New Patient Price $166.88
- Average New Patient Copayment $31.6
- Minimum New Patient Copayment $13.71
- Maximum New Patient Copayment $41.72
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $97.05
- Minimum Established Patient Price $17.52
- Maximum Established Patient Price $136.11
- Average Established Patient Copayment $24.26
- Minimum Established Patient Copayment $4.38
- Maximum Established Patient Copayment $34.02
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Advance Care Planning | Yes | N/A |
| Implementation of practices/processes to develop advance care planning that includes: documenting the advance care plan or living will within the medical record, educating clinicians about advance care planning motivating them to address advance care planning needs of their patients, and how these needs can translate into quality improvement, educating clinicians on approaches and barriers to talking to patients about end-of-life and palliative care needs and ways to manage its documentation, as well as informing clinicians of the healthcare policy side of advance care planning. | ||
| Care Plan | 99% | 559 |
| Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan | ||
| Documentation of Current Medications in the Medical Record | 99% | 291 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Engagement of Patients, Family, and Caregivers in Developing a Plan of Care | Yes | N/A |
| Engage patients, family, and caregivers in developing a plan of care and prioritizing their goals for action, documented in the electronic health record (EHR) technology. | ||
| Implementation of an ASP | Yes | N/A |
| Change Activity Description to: Leadership of an Antimicrobial Stewardship Program (ASP) that includes implementation of an ASP that measures the appropriate use of antibiotics for several different conditions (such as but not limited to upper respiratory infection treatment in children, diagnosis of pharyngitis, bronchitis treatment in adults) according to clinical guidelines for diagnostics and therapeutics. Specific activities may include: • Develop facility-specific antibiogram and prepare report of findings with specific action plan that aligns with overall facility or practice strategic plan. • Lead the development, implementation, and monitoring of patient care and patient safety protocols for the delivery of ASP including protocols pertaining to the most appropriate setting for such services (i.e., outpatient or inpatient). • Assist in improving ASP service line efficiency and effectiveness by evaluating and recommending improvements in the management structure and workflow of ASP processes. • Manage compliance of the ASP policies and assist with implementation of corrective actions in accordance with facility or clinic compliance policies and hospital medical staff by-laws. • Lead the education and training of professional support staff for the purpose of maintaining an efficient and effective ASP. • Coordinate communications between ASP management and facility or practice personnel regarding activities, services, and operational/clinical protocols to achieve overall compliance and understanding of the ASP. • Assist, at the request of the facility or practice, in preparing for and responding to third-party requests, including but not limited to payer audits, governmental inquiries, and professional inquiries that pertain to the ASP service line. • Implementing and tracking an evidence-based policy or practice aimed at improving antibiotic prescribing practices for high-priority conditions. • Developing and implementing evidence-based protocols and decision-support for diagnosis and treatment of common infections. • Implementing evidence-based protocols that align with recommendations in the Centers for Disease Control and Prevention’s Core Elements of Outpatient Antibiotic Stewardship guidance | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Sujesh Pillai is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| HOUSTON METHODIST THE WOODLANDS HOSPITAL | 17201 INTERSTATE 45 SOUTH THE WOODLANDS, TX 77385 | (936) 270-2000 | Acute Care Hospitals |
Reviews for DR. SUJESH SATHYAN PILLAI MD
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1497947071, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 69 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
SHENANDOAH, TX 77385
THE WOODLANDS, TX 77385
SHENANDOAH, TX 77385
THE WOODLANDS, TX 77385
THE WOODLANDS, TX 77385
THE WOODLANDS, TX 77385
THE WOODLANDS, TX 77385
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1497947071, enumerated as an "individual" on August 16, 2007.
The provider is located at 17201 INTERSTATE 45 S THE WOODLANDS, TX 77385 and the phone number is (936) 270-2099.
Hospitalist with taxonomy code 208M00000X.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas, Community. Please consult your insurance carrier or call the provider to verify.
Sujesh Pillai is affiliated with: HOUSTON METHODIST THE WOODLANDS HOSPITAL.
