DR. VIKASH KUMAR SINHA MD
NPI 1740628726
Internal Medicine - Nephrology in Merrillville, IN

Active since June 12, 2013PECOS EnrolledAccepts Medicare Assignment
72.78/100
CMS Quality Rating
757 E 81ST AVE, MERRILLVILLE, IN 46410(219) 472-0379 Get Directions Write a Review

NPPES record last updated: October 29, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 15, 2022, Dec 20, 2018, Mar 16, 2018 (3 updates tracked since 2018).

About Dr. Vikash Kumar Sinha Md NPPES

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

DR. VIKASH KUMAR SINHA MD (NPI 1740628726) is an individual nephrology provider in Merrillville, Indiana, licensed in Indiana (01074975A) and active in the NPI registry since June 2013. He is enrolled in Medicare PECOS, is affiliated with Northwestern Medicine Central Dupage Hospital, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1740628726
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameDR. VIKASH KUMAR SINHACredential: MD
Location Address757 E 81ST AVEMerrillville, IN 46410-5538
Mailing AddressPo Box 3877Joliet, IL 60434-3877 · (815) 741-6830
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateJune 12, 2013
Last NPPES UpdateOctober 29, 20243 updates tracked since enumeration
NPPES CertifiedOctober 29, 2024
NPI 1740628726 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Licenses Licensed in IN · 01074975A Licensed in IL · 036132987
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
757 E 81ST AVE, Merrillville, IN 46410

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. Vikash Kumar Sinha 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 ID8921319989
PECOS Enrollment IDI20150617000598, I20151023000397
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 14

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.
1,301 services239 patients
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.
370 services189 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
310 services57 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.
261 services214 patients
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439
Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.
168 services54 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
167 services104 patients

Hospital Affiliations CMS Care Compare 4

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

Northwestern Medicine Central Dupage Hospital

Acute Care Hospitals · Winfield, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140242
Location25 North Winfield RoadWinfield, IL 60190 · Du Page County
Emergency services Birthing friendly

Methodist Hospitals Inc

Acute Care Hospitals · Gary, IN
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150002
Location600 Grant StGary, IN 46402 · Lake County
Emergency services Birthing friendly

St Mary Medical Center Inc

Acute Care Hospitals · Hobart, IN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150034
Location1500 S Lake Park AveHobart, IN 46342 · Lake County
Emergency services Birthing friendly

Community Hospital

Acute Care Hospitals · Munster, IN
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150125
Location901 Macarthur BlvdMunster, IN 46321 · Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46410 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
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

72.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality66.46
Promoting Interoperability84
Improvement Activities40
Cost30.29

Reported Quality Measures

Advance Care Plan
1%1,137 patients1/55-star benchmark: 100%
Colorectal Cancer Screening
0%551 patients1/55-star benchmark: 88%
Controlling High Blood Pressure
66%568 patients3/55-star benchmark: 91%
Diabetes: Eye Exam
0%269 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
77%269 patients2/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
61%3,743 patients2/55-star benchmark: 100%
e-Prescribing
98%489 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
15%861 patients1/55-star benchmark: 98%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
25%532 patients2/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 0% · 652 patients
0%652 patients
Provide Patients Electronic Access to Their Health Information
18%535 patients1/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
84%341 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 600 patients
Patients totalRate: 2% · 600 patients
2%600 patients4/55-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 4

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

Dentist
757 E 81ST AVE
MERRILLVILLE, IN 46410
Internal Medicine (Nephrology)
757 E 81ST AVE
MERRILLVILLE, IN 46410
Internal Medicine (Nephrology)
757 E 81ST AVE
MERRILLVILLE, IN 46410
Internal Medicine (Nephrology)
757 E 81ST AVE
MERRILLVILLE, IN 46410

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 Vikash Sinha's NPI number?

The NPI number for Vikash Sinha is 1740628726. It was assigned to this individual provider in the NPPES registry on June 12, 2013.

Where is Vikash Sinha located?

Vikash Sinha practices at 757 E 81st Ave, Merrillville, IN 46410. The listed phone number is (219) 472-0379.

What is Vikash Sinha's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Vikash Sinha enrolled in Medicare?

Yes. Vikash Sinha 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 Vikash Sinha accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Buckeye Health Plan, Ambetter from Home State Health and Ambetter from Meridian and 1 other insurer list Vikash Sinha 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 Vikash Sinha affiliated with any hospitals?

According to CMS data, Vikash Sinha is affiliated with Northwestern Medicine Central Dupage Hospital, Methodist Hospitals Inc, St Mary Medical Center Inc and Community Hospital.

When was this NPI record last updated?

The NPPES record for Vikash Sinha was last updated on October 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.