DR. SHERIF M ELTAWANSY M.D.
NPI 1518308949
Internal Medicine in Somerset, PA

Q: What is Sherif M Eltawansy's NPI number?

The NPI number for Sherif M Eltawansy is 1518308949. It was assigned to this individual provider in the NPPES registry on July 14, 2013.

Q: What is Sherif M Eltawansy's specialty?

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

Active since July 14, 2013PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

225 S CENTER AVE, SOMERSET, PA 15501(814) 443-5000 Get Directions Write a Review

NPPES record last updated: January 3, 2019. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Jan 3, 2019, May 10, 2016 (2 updates tracked since 2016).

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About Dr. Sherif M Eltawansy M.d. NPPES

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

DR. SHERIF M ELTAWANSY M.D. (NPI 1518308949) is an individual internal medicine provider in Somerset, Pennsylvania, licensed in New Jersey (P14-00321) and active in the NPI registry since July 2013. He is enrolled in Medicare PECOS, is affiliated with Deborah Heart And Lung Center, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1518308949

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. SHERIF M ELTAWANSYCredential: M.D.

Location Address225 S CENTER AVESomerset, PA 15501-2033

Mailing Address300 2nd AveLong Branch, NJ 07740-6303 · (732) 208-4470

Phone(814) 443-5000

Sole ProprietorNo

Medical School CMSOtherGraduated 2004

Enumeration DateJuly 14, 2013

Last NPPES UpdateJanuary 3, 20192 updates tracked since enumeration

✔ NPI 1518308949 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in NJ · P14-00321

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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

225 S CENTER AVE, Somerset, PA 15501

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.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. Sherif M Eltawansy 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 ID3678861408

PECOS Enrollment IDI20200708000589

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 5

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-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.

967 services416 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

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.

431 services246 patients

Hospital discharge day management, more than 30 minutes 99239

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.

354 services348 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

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.

337 services335 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

53 services53 patients

Hospital Affiliations CMS Care Compare 5

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

Deborah Heart And Lung Center

Acute Care Hospitals · Browns Mills, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310031

Location200 Trenton RoadBrowns Mills, NJ 08015 · Burlington County

Capital Health Medical Center - Hopewell

Acute Care Hospitals · Pennington, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310044

LocationOne Capital WayPennington, NJ 08534 · Mercer County

Emergency services Birthing friendly

Ocean Medical Center

Acute Care Hospitals · Brick, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number310052

Location425 Jack Martin BlvdBrick, NJ 08724 · Ocean County

Emergency services Birthing friendly

Jersey Shore University Medical Center

Acute Care Hospitals · Neptune, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310073

Location1945 State Route 33Neptune, NJ 07753 · Monmouth County

Emergency services Birthing friendly

Southern Ocean Medical Center

Acute Care Hospitals · Manahawkin, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310113

Location1140 Rt 72 WManahawkin, NJ 08050 · Ocean County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15501 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

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

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.

75/100

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

Scored as part of a group practice

Reported Quality Measures

Care Plan

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…

100%161 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 20

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

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