SURESH MATHEW MD
NPI 1922070614
Internal Medicine - Nephrology in Saint Louis, MO

Active since February 06, 2006PECOS EnrolledAccepts Medicare Assignment
11125 DUNN RD, SUITE 304, SAINT LOUIS, MO 63136(314) 355-1166(314) 355-9179 Get Directions Write a Review

NPPES record last updated: March 14, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Suresh Mathew Md NPPES

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

SURESH MATHEW MD (NPI 1922070614) is an individual nephrology provider in Saint Louis, Missouri, licensed in Missouri (20022016480) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Alton Memorial Hospital, and is a graduate of Temple University School Of Medicine (1992).

NPPES Registry Identity

NPI1922070614
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameSURESH MATHEWCredential: MD
Location Address11125 DUNN RD, SUITE 304Saint Louis, MO 63136-6132
Mailing Address11125 Dunn Rd, Suite 304Saint Louis, MO 63136-6132 · (314) 355-1166 · Fax (314) 355-9179
Fax(314) 355-9179
Sole ProprietorYes
Medical School CMSTemple University School Of MedicineGraduated 1992
Enumeration DateFebruary 6, 2006
Last NPPES UpdateMarch 14, 2022
NPPES CertifiedMarch 14, 2022
NPI 1922070614 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 MO · 20022016480 Licensed in MO · 2002016480
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.
11125 DUNN RD, Saint Louis, MO 63136

Other Identifiers 2

Medicaid205931108MO
Medicaid2002016480MO

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

Suresh Mathew 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 ID6002805090
PECOS Enrollment IDI20040506000710, I20040624000757
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 6

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.
1,509 services189 patients
Dialysis services, 1 physician visit per month (20 years or older) 90962
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can’t do their job. A physician visit once a month ensures your treatment is working effectively and adjusts it if necessary. This service is available for individuals aged 20 years and older.
241 services43 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.
220 services173 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.
209 services99 patients
Dialysis services, 2-3 physician visits per month (20 years or older) 90961
Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.
80 services28 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.
24 services24 patients

Hospital Affiliations CMS Care Compare 5

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

Alton Memorial Hospital

Acute Care Hospitals · Alton, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140002
LocationOne Memorial DriveAlton, IL 62002 · Madison County
Emergency services Birthing friendly

Ssm Health Depaul Hospital St Louis

Acute Care Hospitals · Bridgeton, MO
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number260104
Location12303 Depaul DriveBridgeton, MO 63044 · St. Louis County
Emergency services Birthing friendly

Missouri Baptist Medical Center

Acute Care Hospitals · Town And Country, MO
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260108
Location3015 N Ballas RdTown And Country, MO 63131 · St. Louis County
Emergency services Birthing friendly

Christian Hospital Northeast

Acute Care Hospitals · Saint Louis, MO
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260180
Location11133 Dunn RoadSaint Louis, MO 63136 · St. Louis County
Emergency services

Barnes-Jewish St Peters Hospital

Acute Care Hospitals · Saint Peters, MO
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number260191
Location10 Hospital DrSaint Peters, MO 63376 · St. Charles County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63136 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
$128.28 typical visit price
range $55.65 – $169.38
Typical copayment $32.07 (range $13.91 – $42.34)
Most-billed visit code 99204
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
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

Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
100%104 patients5/55-star benchmark: 99%
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%887 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.
81%116 patients2/55-star benchmark: 99%
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%21 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
37%172 patients2/55-star benchmark: 97%
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…
24%440 patients2/55-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…
99%172 patients4/55-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…
34%172 patients2/55-star benchmark: 89%
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.
3%172 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 20

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

Counselor (Professional)
11125 DUNN RD
SAINT LOUIS, MO 63136
Nurse Practitioner (Family)
11125 DUNN RD, DEPT OTOLARYNGOLOGY, STE 201
SAINT LOUIS, MO 63136
Nursing Facility/Intermediate Care Facility
11125 DUNN RD, SUITE 411
SAINT LOUIS, MO 63136
Psychiatry & Neurology (Neurology)
11125 DUNN RD, DEPT NEUROLOGY, STE 110
SAINT LOUIS, MO 63136
Family Medicine
11125 DUNN RD, STE 406
SAINT LOUIS, MO 63136
Surgery
11125 DUNN RD, STE 402
SAINT LOUIS, MO 63136
Internal Medicine (Cardiovascular Disease)
11125 DUNN RD, STE 204
SAINT LOUIS, MO 63136
Internal Medicine (Nephrology)
11125 DUNN RD, SUITE 206
SAINT LOUIS, MO 63136

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 Suresh Mathew's NPI number?

The NPI number for Suresh Mathew is 1922070614. It was assigned to this individual provider in the NPPES registry on February 6, 2006.

Where is Suresh Mathew located?

Suresh Mathew practices at 11125 Dunn Rd Suite 304, Saint Louis, MO 63136. The listed phone number is (314) 355-1166.

What is Suresh Mathew's specialty?

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

Is Suresh Mathew enrolled in Medicare?

Yes. Suresh Mathew 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 Suresh Mathew accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 2 other insurers list Suresh Mathew 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 Suresh Mathew affiliated with any hospitals?

According to CMS data, Suresh Mathew is affiliated with Alton Memorial Hospital, Ssm Health Depaul Hospital St Louis, Missouri Baptist Medical Center, Christian Hospital Northeast and Barnes-Jewish St Peters Hospital.

When was this NPI record last updated?

The NPPES record for Suresh Mathew was last updated on March 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.