DR. KULDIP SHARMA M.D.
NPI 1578541017
Internal Medicine - Gastroenterology in Middletown, OH

Active since January 05, 2006PECOS EnrolledAccepts Medicare Assignment
87.66/100
CMS Quality Rating
255 N BREIEL BLVD, MIDDLETOWN, OH 45042(513) 422-5915(513) 422-5101 Get Directions Write a Review

NPPES record last updated: August 17, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Kuldip Sharma M.d. NPPES

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

DR. KULDIP SHARMA M.D. (NPI 1578541017) is an individual gastroenterology provider in Middletown, Ohio, licensed in Ohio (35059854S) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Miami Valley Hospital, and is a graduate of Other (1977).

NPPES Registry Identity

NPI1578541017
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. KULDIP SHARMACredential: M.D.
Location Address255 N BREIEL BLVDMiddletown, OH 45042-3807
Mailing Address255 N Breiel BlvdMiddletown, OH 45042-3807 · (513) 422-5915 · Fax (513) 422-5101
Fax(513) 422-5101
Sole ProprietorNo
Medical School CMSOtherGraduated 1977
Enumeration DateJanuary 5, 2006
Last NPPES UpdateAugust 17, 2011
NPI 1578541017 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 OH · 35059854S
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.
255 N BREIEL BLVD, Middletown, OH 45042

Other Identifiers 6

Other141120002OH · Caresource
Medicare PIN0690632OH
Medicare UPINE80166OH
OtherP00010308OH · Rrmc
Medicaid0835467OH
Other000000232753OH · Anthem

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. Kuldip Sharma 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 ID8729011655
PECOS Enrollment IDI20110128000948
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 12

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.

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
165 services165 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.
124 services115 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
123 services123 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.
93 services93 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.
67 services64 patients
Colorectal cancer screening; colonoscopy on individual at high risk G0105
Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.
49 services49 patients

Hospital Affiliations CMS Care Compare 2

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

Miami Valley Hospital

Acute Care Hospitals · Dayton, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360051
LocationOne Wyoming StreetDayton, OH 45409 · Montgomery County
Emergency services Birthing friendly

Atrium Medical Center

Acute Care Hospitals · Franklin, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360076
LocationOne Medical Center DriveFranklin, OH 45005 · Warren County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45042 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
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.10 – $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.

87.66/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality76.9
Improvement Activities40
Cost89.67

Other Providers at the Same Location NPPES 4

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

Physician Assistant
255 N BREIEL BLVD
MIDDLETOWN, OH 45042
Specialist
255 N BREIEL BLVD
MIDDLETOWN, OH 45042
Internal Medicine (Gastroenterology)
255 N BREIEL BLVD
MIDDLETOWN, OH 45042
Internal Medicine (Gastroenterology)
255 N BREIEL BLVD
MIDDLETOWN, OH 45042

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 Kuldip Sharma's NPI number?

The NPI number for Kuldip Sharma is 1578541017. It was assigned to this individual provider in the NPPES registry on January 5, 2006.

Where is Kuldip Sharma located?

Kuldip Sharma practices at 255 N Breiel Blvd, Middletown, OH 45042. The listed phone number is (513) 422-5915.

What is Kuldip Sharma's specialty?

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

Is Kuldip Sharma enrolled in Medicare?

Yes. Kuldip Sharma 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 Kuldip Sharma accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 1 other insurer list Kuldip Sharma 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 Kuldip Sharma affiliated with any hospitals?

According to CMS data, Kuldip Sharma is affiliated with Miami Valley Hospital and Atrium Medical Center.

When was this NPI record last updated?

The NPPES record for Kuldip Sharma was last updated on August 17, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.