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SANTHOSH AUGUSTINE M.D.
NPI 1689663700
Internal Medicine - Gastroenterology in Lumberton, NC

Active since October 20, 2005PECOS EnrolledAccepts Medicare Assignment
101 W 27TH ST, LUMBERTON, NC 28358(910) 739-0770(910) 739-4102 Get Directions Write a Review

NPPES record last updated: January 23, 2017. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Santhosh Augustine M.d. NPPES

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

SANTHOSH AUGUSTINE M.D. (NPI 1689663700) is an individual gastroenterology provider in Lumberton, North Carolina, licensed in North Carolina (96-00445) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Southeastern Regional Medical Center, and is a graduate of Other (1985).

NPPES Registry Identity

NPI1689663700
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameSANTHOSH AUGUSTINECredential: M.D.
Location Address101 W 27TH STLumberton, NC 28358-3014
Mailing Address101 W 27th StLumberton, NC 28358-3014 · (910) 739-0770 · Fax (910) 739-4102
Phone(910) 739-0770
Fax(910) 739-4102
Sole ProprietorNo
Medical School CMSOtherGraduated 1985
Enumeration DateOctober 20, 2005
Last NPPES UpdateJanuary 23, 2017
✔ NPI 1689663700 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in NC · 96-00445
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.
Also ListedInternal MedicineTaxonomy 207R00000X · License 9600445 (NC)
101 W 27TH ST, Lumberton, NC 28358
Open in Google Maps ↗

Other Identifiers 4

Medicare PIN2223027BNC
Medicare UPING00202
Other19AKQNC · Bcbs
Medicaid8912277NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina 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

Santhosh Augustine 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 ID6002912136
PECOS Enrollment IDI20090326000559
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 Reassignment

Medicare enrollment records show Santhosh Augustine reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Premier Behavioral Services Inc
0.6 mi
Community/Behavioral Health
2003 GODWIN AVE, SUITE B
Lumberton, NC 28358
  • Reassigned Medicare billing, North Carolina enrollment
  • 5 clinicians in this Medicare group
NPI 1457657645 (910) 671-1111

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 4

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
83 services45 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
34 services34 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.
28 services26 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
11 services11 patients

Hospital Affiliations CMS Care Compare

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

Southeastern Regional Medical Center

Acute Care Hospitals · Lumberton, NC
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340050
Location300 W 27 St PO Box 1408Lumberton, NC 28359 · Robeson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28358 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
18%387 patients1/55-star benchmark: 85%
Documentation of Current Medications in the Medical Record
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.
100%1,469 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
21%436 patients1/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
8%39 patients1/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%68 patients5/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
19%636 patients1/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%225 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
23%225 patients2/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 1% · 221 patients
2%221 patients4/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
0%225 patients
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 3

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

SOUTHEASTERN GASTROENTEROLOGY ENDOSCOPY CENTER, PA
Clinic/Center (Ambulatory Surgical)
101 W 27TH ST
LUMBERTON, NC 28358
Robeson County (910) 739-0770
SANTHOSH AUGUSTINE
Clinic/Center (Medical Specialty)
101 W 27TH ST
LUMBERTON, NC 28358
Robeson County (910) 739-0770
LBNC ANESTHESIA SERVICES PC
Nurse Anesthetist, Certified Registered
101 W 27TH ST
LUMBERTON, NC 28358
Robeson County (800) 208-6014

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 Santhosh Augustine's NPI number?

The NPI number for Santhosh Augustine is 1689663700. It was assigned to this individual provider in the NPPES registry on October 20, 2005.

Where is Santhosh Augustine located?

Santhosh Augustine practices at 101 W 27th St, Lumberton, NC 28358. The listed phone number is (910) 739-0770.

What is Santhosh Augustine's specialty?

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

Is Santhosh Augustine enrolled in Medicare?

Yes. Santhosh Augustine 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 organization bills Medicare for Santhosh Augustine's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Santhosh Augustine reassigns Medicare benefits to Premier Behavioral Services Inc (Lumberton, NC). The 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 Santhosh Augustine's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Santhosh Augustine accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and Blue Cross and Blue Shield of NC and 2 other insurers list Santhosh Augustine 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 Santhosh Augustine affiliated with any hospitals?

According to CMS data, Santhosh Augustine is affiliated with Southeastern Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Santhosh Augustine was last updated on January 23, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.