DR. VIDYA MATHIVANAN MD
NPI 1508069659
Internal Medicine in Sugar Land, TX

NPI Status: Active since June 07, 2007

Contact Information

16659 SOUTHWEST FWY
SUGAR LAND, TX
ZIP 77479
Phone: (281) 812-7404

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  • Individual
  • Female
  • Years of Experience 28
  • Internal Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About VIDYA MATHIVANAN

This page provides the complete NPI Profile along with additional information for Vidya Mathivanan, an internist established in Sugar Land, Texas with a medical specialization in Internal Medicine and more than 28 years of experience. The healthcare provider is registered in the NPI registry with number 1508069659 assigned on June 2007. The practitioner's primary taxonomy code is 207R00000X with license number N 3875 (TX). The provider is registered as an individual and her NPI record was last updated 11 years ago.

NPI
1508069659
Provider Name
DR. VIDYA MATHIVANAN MD
Gender
Female
Entity Type
Individual
Location Address
16659 SOUTHWEST FWY SUGAR LAND, TX 77479
Location Phone
(281) 812-7404
Mailing Address
2607 GALLION DR SUGAR LAND, TX 77479
Mailing Phone
(281) 812-7404
Medical School Name
OTHER
Graduation Year
1998
Is Sole Proprietor?
Yes
Enumeration Date
06-07-2007
Last Update Date
02-11-2015
Code Navigator

An internist like Vidya Mathivanan is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

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

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
N 3875
License State
TX
Taxonomy Description
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Community Premier Bronze 003 (No deductible for PCP, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Community Premier Bronze 018 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • 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
  • Community Select Bronze 016 (No deductible for PCP, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Community Select Gold 022 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
  • Community Select Silver 019 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Vidya Mathivanan 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.

Vidya Mathivanan 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), a Home Health Agency (HHA) and Power Mobility Devices.

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: 6507903598

    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: I20091023000320

    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: Yes

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 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 168 times for 48 patients

Hospital discharge day management, 30 minutes or less

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

This service was performed 20 times for 20 patients

Hospital discharge day management, more than 30 minutes

Hospital 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 15 times for 15 patients

Hospital observation care on day of discharge

Hospital 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 21 times for 20 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial 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 15 times for 15 patients

Initial hospital observation care per day, typically 70 minutes

This 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 11 times for 11 patients

Physician 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 77479 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 PlanningYesN/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 70% 356
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 100% 206
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
Implementation of fall screening and assessment programsYesN/A
Implementation of fall screening and assessment programs to identify patients at risk for falls and address modifiable risk factors (e.g., Clinical decision support/prompts in the electronic health record that help manage the use of medications, such as benzodiazepines, that increase fall risk).

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. Vidya Mathivanan is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
MEMORIAL HERMANN HOSPITAL SYSTEM1635 NORTH LOOP WEST
HOUSTON, TX 77008
(713) 448-6796Acute Care Hospitals

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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 1508069659, we treat the final digit (9) 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 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

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.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
0
Doubled → 0
Pos 4
8
Unchanged
Pos 5
0
Doubled → 0
Pos 6
6
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
6
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
9
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 0 → 0 0 → 0 9 → 18 → 9 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 0 + 8 + 0 + 6 + 1 + 8 + 6 + 1 + 0 + 24 = 61

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1508069659.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Family Medicine
16659 SOUTHWEST FWY, SUITE 301
SUGAR LAND, TX 77479
Pediatrics
16659 SOUTHWEST FWY, SUITE 301
SUGAR LAND, TX 77479
Urology
16659 SOUTHWEST FWY, SUITE 141
SUGAR LAND, TX 77479
Family Medicine
16659 SOUTHWEST FWY, SUITE 461
SUGAR LAND, TX 77479
Urology
16659 SOUTHWEST FWY, SUITE 225
SUGAR LAND, TX 77479
Urology
16659 SOUTHWEST FWY, MEDICAL OFFICE BLDG II, STE 225
SUGAR LAND, TX 77479
Dentist
16659 SOUTHWEST FWY, SUITE 175
SUGAR LAND, TX 77479
Psychiatry & Neurology (Neurology)
16659 SOUTHWEST FWY, SUITE 131
SUGAR LAND, TX 77479
Podiatrist
16659 SOUTHWEST FWY, 175
SUGAR LAND, TX 77479
Specialist
16659 SOUTHWEST FWY, SUITE 561
SUGAR LAND, TX 77479
Specialist
16659 SOUTHWEST FWY, SUITE 151
SUGAR LAND, TX 77479
Physician Assistant (Medical)
16659 SOUTHWEST FWY, SUITE 235
SUGAR LAND, TX 77479
Internal Medicine (Rheumatology)
16659 SOUTHWEST FWY, SUITE 235
SUGAR LAND, TX 77479
Physical Therapist
16659 SOUTHWEST FWY, SUITE 461
SUGAR LAND, TX 77479
Internal Medicine (Nephrology)
16659 SOUTHWEST FWY, # 561
SUGAR LAND, TX 77479
Internal Medicine (Rheumatology)
16659 SOUTHWEST FWY, SUITE 235
SUGAR LAND, TX 77479
Surgery
16659 SOUTHWEST FWY, SUITE 561
SUGAR LAND, TX 77479
Clinical Neuropsychologist
16659 SOUTHWEST FWY, SUITE 131
SUGAR LAND, TX 77479
Colon & Rectal Surgery
16659 SOUTHWEST FWY, SUITE 561
SUGAR LAND, TX 77479
Specialist/Technologist, Other (Electroneurodiagnostic)
16659 SOUTHWEST FWY, SUITE 151
SUGAR LAND, TX 77479

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1508069659, enumerated as an "individual" on June 07, 2007.

The provider is located at 16659 SOUTHWEST FWY SUGAR LAND, TX 77479 and the phone number is (281) 812-7404.

Internal Medicine with taxonomy code 207R00000X.

The provider might be accepting Accepts: Community Health Choice. Please consult your insurance carrier or call the provider to verify.

Vidya Mathivanan is affiliated with: MEMORIAL HERMANN HOSPITAL SYSTEM.