SENTHIL SANKARALINGAM MD
NPI 1457546186
Surgery in Killeen, TX


Quality Rating: 83.1 out of 100 score

NPI Status: Active since September 06, 2007

Contact Information

3816 S CLEAR CREEK RD
KILLEEN, TX
ZIP 76549
Phone: (254) 526-8446

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  • Individual
  • Male
  • Years of Experience 24
  • Surgery
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About SENTHIL SANKARALINGAM

This page provides the complete NPI Profile along with additional information for Senthil Sankaralingam, a provider established in Killeen, Texas with a medical specialization in Surgery and more than 24 years of experience. He graduated from University Of Hawaii John A. Burns School Of Medicine in 2002. The healthcare provider is registered in the NPI registry with number 1457546186 assigned on September 2007. The practitioner's primary taxonomy code is 208600000X with license number M6864 (TX). The provider is registered as an individual and his NPI record was last updated 16 years ago.

NPI
1457546186
Provider Name
SENTHIL SANKARALINGAM MD
Gender
Male
Entity Type
Individual
Location Address
3816 S CLEAR CREEK RD KILLEEN, TX 76549
Location Phone
(254) 526-8446
Mailing Address
PO BOX 938 KILLEEN, TX 76540
Mailing Phone
(254) 634-6999
Mailing Fax
Medical School Name
UNIVERSITY OF HAWAII JOHN A. BURNS SCHOOL OF MEDICINE
Graduation Year
2002
Is Sole Proprietor?
No
Enumeration Date
09-06-2007
Last Update Date
09-01-2009
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A surgeon like Senthil Sankaralingam treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.

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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

Surgery

Taxonomy Code
208600000X
Type
Allopathic & Osteopathic Physicians
License No.
M6864
License State
TX
Taxonomy Description
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO
  • Bronze Classic 4700 - EPO
  • Bronze Classic Standard - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Gold Classic - EPO
  • Gold Classic Standard - EPO
  • Gold Elite - EPO
  • Silver Classic - EPO
  • Silver Classic Standard - EPO
  • Silver Simple PCP Saver - EPO

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
M6864OTHER (01)TXTX MEDICAL LICENSE

Medicare Participation & PECOS Enrollment Status

Senthil Sankaralingam 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.

Senthil Sankaralingam 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: 244329852

    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: I20071205000216

    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

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $21.23 for a new patient copayment and $17.13 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 76549 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $84.92
  • Minimum New Patient Price $54.84
  • Maximum New Patient Price $166.88
  • Average New Patient Copayment $21.23
  • Minimum New Patient Copayment $13.71
  • Maximum New Patient Copayment $41.72

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $68.55
  • Minimum Established Patient Price $17.52
  • Maximum Established Patient Price $136.11
  • Average Established Patient Copayment $17.13
  • Minimum Established Patient Copayment $4.38
  • Maximum Established Patient Copayment $34.02

* 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.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 83.1, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 83.1 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 99.87

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 83

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: 57.96

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: 57.96

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Annual registration in the Prescription Drug Monitoring ProgramYesN/A
Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months.
Breast Cancer Screening 7% 172
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
Care transition documentation practice improvementsYesN/A
Implementation of practices/processes for care transition that include documentation of how a MIPS eligible clinician or group carried out a patient-centered action plan for first 30 days following a discharge (e.g., staff involved, phone calls conducted in support of transition, accompaniments, navigation actions, home visits, patient information access, etc.).
Collection and follow-up on patient experience and satisfaction data on beneficiary engagementYesN/A
Collection and follow-up on patient experience and satisfaction data on beneficiary engagement, including development of improvement plan.
Collection and use of patient experience and satisfaction data on accessYesN/A
Collection of patient experience and satisfaction data on access to care and development of an improvement plan, such as outlining steps for improving communications with patients to help understanding of urgent access needs.
Colorectal Cancer Screening 19% 317
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Engagement of New Medicaid Patients and Follow-upYesN/A
Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity.
Implementation of formal quality improvement methods, practice changes, or other practice improvement processesYesN/A
Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following such as: • Multi-Source Feedback; • Train all staff in quality improvement methods; • Integrate practice change/quality improvement into staff duties; • Engage all staff in identifying and testing practices changes; • Designate regular team meetings to review data and plan improvement cycles; • Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff; and/or • Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data.
Leadership engagement in regular guidance and demonstrated commitment for implementing practice improvement changesYesN/A
Ensure full engagement of clinical and administrative leadership in practice improvement that could include one or more of the following: Make responsibility for guidance of practice change a component of clinical and administrative leadership roles; Allocate time for clinical and administrative leadership for practice improvement efforts, including participation in regular team meetings; and/or Incorporate population health, quality and patient experience metrics in regular reviews of practice performance.
Participation in CAHPS or other supplemental questionnaireYesN/A
Participation in the Consumer Assessment of Healthcare Providers and Systems Survey or other supplemental questionnaire items (e.g., Cultural Competence or Health Information Technology supplemental item sets).
Pneumococcal Vaccination Status for Older Adults 11% 192
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Tobacco useYesN/A
Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence.

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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.
1457546186
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2410710412116
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 1 + 0 + 7 + 1 + 0 + 4 + 1 + 2 + 1 + 1 + 6 + 24 = 54
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 54 = 66

The NPI number 1457546186 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 18 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1518941277 JEANICE AMY MITCHELL MPT
Individual
Physical Therapist3816 S CLEAR CREEK RD SUITE B
KILLEEN, TX 76549
(254) 699-3933
1972587632 KIDADA A MITCHELL OTR
Individual
Occupational Therapist3816 S CLEAR CREEK RD SUITE B
KILLEEN, TX 76549
(254) 699-3933
1285730705DR. CHARLES WALTER MITCHELL M.D.
Individual
Family Medicine3816 S CLEAR CREEK RD SUITE E
KILLEEN, TX 76549
(254) 554-8773
1386726735DR. STEPHEN RALPH M.D.
Individual
Internal Medicine3816 S CLEAR CREEK RD SUITE E
KILLEEN, TX 76549
(254) 554-8773
1679783989 JENISE M ENGELKE PT, DPT
Individual
Physical Therapist3816 S CLEAR CREEK RD SUITE B
KILLEEN, TX 76549
(254) 699-3933
1477716843 LEAH ELLIS DPT
Individual
Physical Therapist3816 S CLEAR CREEK RD SUITE B
KILLEEN, TX 76549
(254) 699-3933
1124273719 DONNA C WORTHY MPT
Individual
Physical Therapist3816 S CLEAR CREEK RD STE B
KILLEEN, TX 76549
(254) 699-3933
1649408246CENTRAL TEXAS SURGICARE PA
Organization
Surgery3816 S CLEAR CREEK RD STE B
KILLEEN, TX 76549
(254) 526-8446
1205108032CTEMS INC
Organization
Family Medicine3816 S CLEAR CREEK RD STE. E
KILLEEN, TX 76549
(254) 554-8773
1225392061MITCHELL HOME VISITS PLLC
Organization
Emergency Medicine3816 S CLEAR CREEK RD
KILLEEN, TX 76549
(254) 554-8773
1023458775 LORIA ANN LOFTON LMFT
Individual
Marriage & Family Therapist3816 S CLEAR CREEK RD BLDG C, STE. 301
KILLEEN, TX 76549
(254) 690-5847
1609896497 JACQUELENE MITCHELL ADIELE M.D.
Individual
Internal Medicine3816 S CLEAR CREEK RD SUITE A
KILLEEN, TX 76549
(254) 200-2748
1306106687JACQUELENE MITCHELL ADIELE, MD, PA
Organization
Internal Medicine3816 S CLEAR CREEK RD SUITE A
KILLEEN, TX 76549
(254) 200-2748
1144286980DR. RICKY D MITCHELL M.D.
Individual
Pediatrics3816 S CLEAR CREEK RD SUITE E
KILLEEN, TX 76549
(254) 554-8773
1932579455ALISA A CROSS MD PA
Organization
Psychiatry & Neurology (Psychiatry)3816 S CLEAR CREEK RD SUITE B
KILLEEN, TX 76549
(254) 220-4474
1669509337INTEGRITY REHAB CLINIC
Organization
Speech-Language Pathologist3816 S CLEAR CREEK RD SUITE B
KILLEEN, TX 76549
(254) 554-8100
1992886840DR. ALISA A CROSS MD
Individual
Psychiatry & Neurology (Psychiatry)3816 S CLEAR CREEK RD SUTE B
KILLEEN, TX 76549
(254) 220-4474
1922431592 DONNALEE ANNE POLLACK NP-C
Individual
Nurse Practitioner (Family)3816 S CLEAR CREEK RD
KILLEEN, TX 76549
(254) 554-8773

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1457546186, enumerated in the NPI registry as an "individual" on September 06, 2007

The provider is located at 3816 S Clear Creek Rd Killeen, Tx 76549 and the phone number is (254) 526-8446

The provider's speciality is Surgery with taxonomy code 208600000X

The provider has more than 24 years of experience. He graduated from University Of Hawaii John A. Burns School Of Medicine in 2002.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas, Oscar. 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.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $84.92 with an average copayment of $21.23 for new patient appointments. Established patients should expect a typical charge of $68.55 and an average copayment of 17.13. Please review your insurance plan or contact the provider directly to determine your specific costs.

This NPI record was last updated on September 06, 2007. 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].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.