DR. SEAN BHALLA M.D.
NPI 1912311325
Internal Medicine - Gastroenterology in Aurora, CO

Q: What is Sean Bhalla's NPI number?

The NPI number for Sean Bhalla is 1912311325. It was assigned to this individual provider in the NPPES registry on June 13, 2014.

Q: What is Sean Bhalla's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Sean Bhalla was last updated on September 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since June 13, 2014PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

1635 AURORA CT, AURORA, CO 80045(720) 848-0000 Get Directions Write a Review

NPPES record last updated: September 2, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 2, 2025, Aug 7, 2025, Jun 5, 2023 and 1 more (4 updates tracked since 2020).

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About Dr. Sean Bhalla M.d. NPPES

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

DR. SEAN BHALLA M.D. (NPI 1912311325) is an individual gastroenterology provider in Aurora, Colorado, licensed in Colorado (DR.0075392) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS and is a graduate of George Washington University School Of Medicine (2014).

NPPES Registry Identity

NPI1912311325

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameDR. SEAN BHALLACredential: M.D.

Location Address1635 AURORA CTAurora, CO 80045-2541

Mailing AddressPo Box 110429Aurora, CO 80042-0429

Phone(720) 848-0000

Sole ProprietorNo

Medical School CMSGeorge Washington University School Of MedicineGraduated 2014

Enumeration DateJune 13, 2014

Last NPPES UpdateSeptember 2, 20254 updates tracked since enumeration

NPPES CertifiedSeptember 2, 2025

✔ NPI 1912311325 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

Licenses✔ Licensed in CO · DR.0075392✔ Licensed in FL · ME151884

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.

1635 AURORA CT, Aurora, CO 80045

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and more.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. Sean Bhalla 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 ID2466769534

PECOS Enrollment IDI20250820000932

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 13

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.

81 services54 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.

72 services67 patients

Removal of stone or debris from bile or pancreatic duct using a flexible endoscope 43264

This procedure, called an endoscopic retrograde cholangiopancreatography (ERCP), involves using a flexible tube with a camera (endoscope) to locate and remove stones or debris from your bile or pancreatic duct. It's a non-surgical method to clear the ducts, enhancing your digestive health.

47 services29 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.

39 services29 patients

Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43259

This procedure involves a flexible tube with a camera, called an endoscope, inserted through your mouth to examine your esophagus, stomach, and upper small bowel. An ultrasound device on the endoscope helps get detailed images. It's safe and helps diagnose various conditions.

33 services32 patients

Ultrasound guided needle aspiration or biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43242

This procedure involves using an ultrasound to guide a needle to specific areas in the esophagus, stomach, or upper small bowel. A flexible endoscope is used to reach these areas. The needle collects a small sample for testing.

28 services28 patients

Insertion of stent into pancreatic or bile duct using a flexible endoscope 43274

This procedure involves the placement of a tiny tube, known as a stent, into your pancreatic or bile duct. A flexible endoscope, a long, thin instrument with a light and camera, is used. It aids in relieving blockages and improving flow in these ducts.

25 services20 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.

20 services18 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.

18 services18 patients

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.

16 services15 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.

14 services13 patients

Removal of stent from pancreatic or bile duct using a flexible endoscope 43275

This procedure involves removing a stent from your pancreatic or bile duct. A flexible endoscope, a thin tube with a light and camera, is used to locate the stent. Once found, it's carefully extracted. This helps maintain proper duct function.

12 services12 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.

12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80045 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

$132.55 typical visit price

range $58.06 – $174.82

Typical copayment $33.13 (range $14.51 – $43.70)

Most-billed visit code 99204

Established Patient

$102.03 typical visit price

range $18.88 – $142.79

Typical copayment $25.50 (range $4.72 – $35.69)

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.

100/100

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

Individually scored

Quality

100

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Breast Cancer Screening

34%58 patients2/55-star benchmark: 93%

Cervical Cancer Screening

23%87 patients1/55-star benchmark: 98%

Colorectal Cancer Screening

69%109 patients4/55-star benchmark: 88%

Controlling High Blood Pressure

78%46 patients4/55-star benchmark: 91%

Diabetes: Eye Exam

46%28 patients2/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

36%28 patients3/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

96%241 patients4/55-star benchmark: 100%

e-Prescribing

100%214 patients5/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

100%58 patients5/55-star benchmark: 100%

HIV Screening

38%142 patients3/55-star benchmark: 60%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

51%180 patients3/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

89%159 patients4/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

45%175 patients3/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients screened: 100% · 33 patients

97%33 patients

Provide Patients Electronic Access to Their Health Information

100%66 patients5/55-star benchmark: 100%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 13% · 62 patients

Patients totalRate: 29% · 62 patients

21%62 patients2/55-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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