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SUNIL KAMNANI MD
NPI 1538523527
Internal Medicine in Edinburg, TX

Active since April 06, 2016PECOS EnrolledAccepts Medicare Assignment
5423 S MCCOLL RD, EDINBURG, TX 78539(956) 362-8677 Get Directions Write a Review

NPPES record last updated: August 3, 2016. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Sunil Kamnani Md NPPES

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

SUNIL KAMNANI MD (NPI 1538523527) is an individual internal medicine provider in Edinburg, Texas, licensed in Texas (BP10055790) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS, is affiliated with St David's Medical Center, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1538523527
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameSUNIL KAMNANICredential: MD
Location Address5423 S MCCOLL RDEdinburg, TX 78539-9183
Mailing Address5423 S Mccoll RdEdinburg, TX 78539-9183
Phone(956) 362-8677
Sole ProprietorYes
Medical School CMSOtherGraduated 2016
Enumeration DateApril 6, 2016
Last NPPES UpdateAugust 3, 2016
✔ NPI 1538523527 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in TX · BP10055790
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.
5423 S MCCOLL RD, Edinburg, TX 78539
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, Oscar Insurance Company and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Sunil Kamnani Md 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 ID4688963143
PECOS Enrollment IDI20191206002066
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.

Medicare Billing Reassignments

4

Medicare enrollment records show Sunil Kamnani reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ipc Healthcare Services Of Texas, PLLC
225 mi
Hospitalist
7330 SAN PEDRO AVE, STE 540
San Antonio, TX 78216
  • Reassigned Medicare billing, Texas enrollment
  • 688 clinicians in this Medicare group
NPI 1023403011 (210) 344-7287
Lonestar Pat Associates PA
295 mi
Hospitalist
2400 ROUND ROCK AVE
Round Rock, TX 78681
  • Reassigned Medicare billing, Texas enrollment
  • 206 clinicians in this Medicare group
NPI 1811594203 (512) 341-1000
Hospitalist Medicine Physicians Of Texas, PLLC
314 mi
Internal Medicine
18951 N MEMORIAL DR
Humble, TX 77338
  • Reassigned Medicare billing, Texas enrollment
  • 2,009 clinicians in this Medicare group
NPI 1629307095 (281) 540-7700
Cogent Healthcare Of Texas, PA
465 mi
Internal Medicine
8200 WALNUT HILL LN
Dallas, TX 75231
  • Reassigned Medicare billing, Texas enrollment
  • 1,208 clinicians in this Medicare group
NPI 1992722953 (214) 345-7585

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 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.
310 services85 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.
137 services135 patients
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.
40 services23 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.
31 services30 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.
14 services14 patients

Hospital Affiliations CMS Care Compare

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

St David's Medical Center

Acute Care Hospitals · Austin, TX
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450431
Location919 E 32nd StAustin, TX 78705 · Travis County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78539 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier24 claims30 services$13.71 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier24 claims30 services$51.45 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

MICHAEL F ROTKO MD
Physical Medicine & Rehabilitation
5423 S MCCOLL RD
EDINBURG, TX 78539
Hidalgo County (956) 821-5941
MR. DON CHERIAN RAJAN MD
Student in an Organized Health Care Education/Training Program
5423 S MCCOLL RD
EDINBURGH, TX 78539
Hidalgo County (956) 442-6412
GABRIEL GONZALEZ MD
Surgery (Vascular Surgery)
5423 S MCCOLL RD
EDINBURG, TX 78539
Hidalgo County (956) 362-8170
DR. PERCY MAREENA THOMAS MD
Student in an Organized Health Care Education/Training Program
5423 S MCCOLL RD
EDINBURG, TX 78539
Hidalgo County (956) 362-3515
KARI ELANA WILLIAMS MD
Radiology (Diagnostic Radiology)
5423 S MCCOLL RD
EDINBURG, TX 78539
Hidalgo County (956) 219-4125
LAURA FERNANDA RINCON-RUEDA MD
Student in an Organized Health Care Education/Training Program
5423 S MCCOLL RD
EDINBURG, TX 78539
Hidalgo County (956) 362-3515
IBRAHIM ODEWALE MD
Student in an Organized Health Care Education/Training Program
5423 S MCCOLL RD
EDINBURG, TX 78539
Hidalgo County (956) 821-5941
DR. KIRK REEVES DO
Internal Medicine
5423 S MCCOLL RD
EDINBURG, TX 78539
Hidalgo County (956) 362-3575

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 Sunil Kamnani's NPI number?

The NPI number for Sunil Kamnani is 1538523527. It was assigned to this individual provider in the NPPES registry on April 6, 2016.

Where is Sunil Kamnani located?

Sunil Kamnani practices at 5423 S Mccoll Rd, Edinburg, TX 78539. The listed phone number is (956) 362-8677.

What is Sunil Kamnani's specialty?

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

Is Sunil Kamnani enrolled in Medicare?

Yes. Sunil Kamnani 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.

Which organizations bill Medicare for Sunil Kamnani's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sunil Kamnani reassigns Medicare benefits to 4 organizations: Ipc Healthcare Services Of Texas, PLLC (San Antonio, TX), Lonestar Pat Associates PA (Round Rock, TX), Hospitalist Medicine Physicians Of Texas, PLLC (Humble, TX) and Cogent Healthcare Of Texas, PA (Dallas, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sunil Kamnani's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sunil Kamnani accept?

Health plans from Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, Oscar Insurance Company and Sendero Health Plans, Local Nonprofit list Sunil Kamnani 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 Sunil Kamnani affiliated with any hospitals?

According to CMS data, Sunil Kamnani is affiliated with St David's Medical Center.

When was this NPI record last updated?

The NPPES record for Sunil Kamnani was last updated on August 3, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.