SANJAY A PATWARDHAN M.D.
NPI 1073583803
Internal Medicine in Chesterfield, MO
NPI Status: Active since January 24, 2006
Contact Information
14314 MANDERLEIGH WOODS DR
CHESTERFIELD, MO
ZIP 63017
Phone: (636) 566-8155
Fax: (314) 576-0809
- Individual
- Male
- Years of Experience 38
- Internal Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About SANJAY PATWARDHAN
This page provides the complete NPI Profile along with additional information for Sanjay Patwardhan, an internist established in Chesterfield, Missouri with a medical specialization in Internal Medicine and more than 38 years of experience. The healthcare provider is registered in the NPI registry with number 1073583803 assigned on January 2006. The practitioner's primary taxonomy code is 207R00000X with license number 107804 (MO). The provider is registered as an individual and his NPI record was last updated 12 years ago.
- NPI
- 1073583803
- Provider Name
- SANJAY A PATWARDHAN M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 14314 MANDERLEIGH WOODS DR CHESTERFIELD, MO 63017
- Location Phone
- (636) 566-8155
- Location Fax
- (314) 576-0809
- Mailing Address
- PO BOX 958946 SAINT LOUIS, MO 63195
- Mailing Fax
- (314) 576-0809
- Medical School Name
- OTHER
- Graduation Year
- 1988
- Is Sole Proprietor?
- No
- Enumeration Date
- 01-24-2006
- Last Update Date
- 12-06-2013
- Code Navigator
An internist like Sanjay Patwardhan is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 107804
- License State
- MO
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | 107804 (MO) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 9200 (+ Incentives) - EPO
- Anthem Catastrophic Pathway 9200 (+ Incentives) - EPO
- Anthem Gold Pathway 1500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Heart Healthy Bronze Pathway 4900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Heart Healthy Silver Pathway 2900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Silver Pathway 5000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Silver Pathway 5350 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Silver Pathway 7250 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic Standard - EPO
- Secure - EPO
- Silver Classic Standard - EPO
- Silver Elite Saver Plus - EPO
- Silver Simple Diabetes - EPO
- Silver Simple PCP Saver - EPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus (No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Bronze Value (Rx Copay, No Referrals) - HMO
- UHC Bronze Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Bronze Value+ (Rx Copay, Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Advantage (No Referrals) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Gold Advantage+ (Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Copay Focus (No Referrals) - HMO
- UHC Gold Standard (No Referrals) - EPO
- UHC Gold Standard (Rx Copay, No Referrals) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Silver Advantage (Rx Copay, No Referrals) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Silver Advantage+ (Rx Copay, Dental + Vision, No Referrals) - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 139000042 | MEDICARE PIN (08) | MO | |
| 1073583803 | MEDICAID (05) | MO | |
| 1073583803 | MEDICAID (05) | IL |
Medicare Participation & PECOS Enrollment Status
Sanjay Patwardhan is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Sanjay Patwardhan is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 1153307582
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20040626000339
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
DME-Oxygen and Supplies (DC002N)
Portable oxygen concentrator, rental (HCPCS:E1392)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
DME-Wheelchairs (DD000N)
Standard wheelchair (HCPCS:K0001)
6 DME suppliers used 65 Medicare Claims 66 Services Paid
DME-Wheelchairs (DD000N)
Heavy duty wheelchair (HCPCS:K0006)
1 DME suppliers used 16 Medicare Claims 16 Services Paid
DME-Wheelchairs (DD021N)
Elevating footrests, articulating (telescoping), each (HCPCS:K0053)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Wheelchairs (DD021N)
Elevating leg rests, pair (for use with capped rental wheelchair base) (HCPCS:K0195)
3 DME suppliers used 17 Medicare Claims 17 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Follow-up nursing facility visit per day, typically 10 minutes
Follow-up nursing facility visit per day, typically 15 minutes
Follow-up nursing facility visit per day, typically 15 minutes
Follow-up nursing facility visit per day, typically 25 minutes
Follow-up nursing facility visit per day, typically 25 minutes
Follow-up nursing facility visit per day, typically 35 minutes
Initial hospital inpatient care per day, typically 70 minutes
Initial nursing facility visit per day, typically 45 minutes
Initial nursing facility visit per day, typically 45 minutes
Nursing facility discharge day management, 30 minutes or less
Nursing facility discharge management, more than 30 minutes
This is a routine visit for established patients residing in care facilities like nursing homes or assisted living. The visit typically lasts about 40 minutes, during which the healthcare provider checks your overall health, discusses any concerns, and adjusts care plans as needed.
This service was performed 25 times for 15 patientsFollow-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.
This service was performed 95 times for 43 patientsFollow-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.
This service was performed 77 times for 47 patientsA follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.
This service was performed 14 times for 14 patientsA follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
This service was performed 265 times for 95 patientsA follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
This service was performed 27 times for 21 patientsA follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
This service was performed 718 times for 220 patientsA follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
This service was performed 61 times for 41 patientsA follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
This service was performed 31 times for 20 patientsInitial 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.
This service was performed 16 times for 16 patientsAn initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
This service was performed 209 times for 200 patientsAn initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
This service was performed 25 times for 25 patientsNursing facility discharge day management involves organizing your transition from the nursing facility to your home or another facility. This service, taking 30 minutes or less, includes finalizing medical instructions, arranging follow-up care, and answering any questions.
This service was performed 31 times for 31 patientsNursing facility discharge management over 30 minutes is a comprehensive process where a healthcare team prepares you for leaving the facility. It involves creating a tailored plan, coordinating care, and ensuring a smooth transition to your next care setting.
This service was performed 68 times for 63 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $32.07 for a new patient copayment and $24.59 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 63017 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $128.28
- Minimum New Patient Price $55.65
- Maximum New Patient Price $169.38
- Average New Patient Copayment $32.07
- Minimum New Patient Copayment $13.91
- Maximum New Patient Copayment $42.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $98.37
- Minimum Established Patient Price $17.76
- Maximum Established Patient Price $137.92
- Average Established Patient Copayment $24.59
- Minimum Established Patient Copayment $4.44
- Maximum Established Patient Copayment $34.48
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 7 | 3 | 5 | 8 | 3 | 8 | 0 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 14 | 3 | 10 | 8 | 6 | 8 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 1 + 4 + 3 + 1 + 0 + 8 + 6 + 8 + 0 + 24 = 57 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 57 = 3 | 3 | ||||||||
The NPI number 1073583803 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1790755536 | DR. MANISHA S PATWARDHAN M.D. Individual | Internal Medicine (Adolescent Medicine) | 14314 MANDERLEIGH WOODS DR CHESTERFIELD, MO 63017 (636) 566-8155 |
| 1528336518 | MIDWEST MEDICINE GROUP, LLC Organization | Internal Medicine | 14314 MANDERLEIGH WOODS DR CHESTERFIELD, MO 63017 (636) 566-8155 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1073583803, enumerated in the NPI registry as an "individual" on January 24, 2006
The provider is located at 14314 Manderleigh Woods Dr Chesterfield, Mo 63017 and the phone number is (636) 566-8155
The provider's speciality is Internal Medicine with taxonomy code 207R00000X
The provider has more than 38 years of experience.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Oscar Insurance. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $128.28 with an average copayment of $32.07 for new patient appointments. Established patients should expect a typical charge of $98.37 and an average copayment of 24.59. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes, Follow-up hospital inpatient care per day, typically 25 minutes, Follow-up hospital inpatient care per day, typically 35 minutes, Follow-up nursing facility visit per day, typically 10 minutes, Follow-up nursing facility visit per day, typically 15 minutes, Follow-up nursing facility visit per day, typically 15 minutes, Follow-up nursing facility visit per day, typically 25 minutes, Follow-up nursing facility visit per day, typically 25 minutes, Follow-up nursing facility visit per day, typically 35 minutes, Initial hospital inpatient care per day, typically 70 minutes, Initial nursing facility visit per day, typically 45 minutes, Initial nursing facility visit per day, typically 45 minutes, Nursing facility discharge day management, 30 minutes or less and Nursing facility discharge management, more than 30 minutes.
This NPI record was last updated on January 24, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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