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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

NUTTAVUT SUMRANSUB M.D.
NPI 1003470568
Internal Medicine - Hematology & Oncology in Minneapolis, MN

Active since April 30, 2019PECOS Enrolled
909 FULTON ST SE, MINNEAPOLIS, MN 55455(612) 672-7422 Get Directions Write a Review

NPPES record last updated: July 20, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 20, 2026, Jul 1, 2025, Jun 17, 2024 and 2 more (5 updates tracked since 2019).

About Nuttavut Sumransub M.d. NPPES

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

NUTTAVUT SUMRANSUB M.D. (NPI 1003470568) is an individual hematology & oncology provider in Minneapolis, Minnesota, licensed in Minnesota (81002) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1003470568
Entity TypeIndividualMale
Primary Taxonomy207RH0003X
Provider Legal NameNUTTAVUT SUMRANSUBCredential: M.D.
Location Address909 FULTON ST SEMinneapolis, MN 55455-4800
Mailing Address401 E River Pkwy Ste 131Minneapolis, MN 55455-0368
Phone(612) 672-7422
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateApril 30, 2019
Last NPPES UpdateJuly 20, 20265 updates tracked since enumeration
NPPES CertifiedJuly 20, 2026
✔ NPI 1003470568 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
License✔ Licensed in MN · 81002
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
909 FULTON ST SE, Minneapolis, MN 55455
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nuttavut Sumransub M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6406183532
PECOS Enrollment IDI20260217000355
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55455 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
$168.28 typical visit price
range $56.00 – $168.28
Typical copayment $42.07 (range $14.00 – $42.07)
Most-billed visit code 99205
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
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.

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.

DR. RONALD ALEXANDER REILKOFF M.D.
Internal Medicine (Pulmonary Disease)
909 FULTON ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 672-7422
EUGENIA SHMIDT MD
Internal Medicine (Gastroenterology)
909 FULTON ST SE
MINNEAPOLIS, MN 55455
Hennepin County (507) 284-2511
DR. ROBERT ALLEN MCGOVERN III M.D.
Neurological Surgery
909 FULTON ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 672-7422
KIMBERLY EHLERT PHARMD, RPH
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
909 FULTON ST SE, 3RD FLOOR, CLINIC AND SURGERY CENTER
MINNEAPOLIS, MN 55455
Hennepin County (612) 672-5341
UNIVERSITY OF MINNESOTA HEALTH CLINICS AND SURGERY CENTER INC
Anesthesiology
909 FULTON ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 273-8383
MARY MELTON PHD
Psychologist (Clinical)
909 FULTON ST SE, BUILDING 2
MINNEAPOLIS, MN 55455
Hennepin County (612) 672-7422
DR. BRITTANI LAUREN CONWAY M.D.
Psychiatry & Neurology (Neurology)
909 FULTON ST SE
MINNEAPOLIS, MN 55455
Hennepin County (651) 226-2890
THOMAS MARK SUSZYNSKI MD, PHD
Plastic Surgery
909 FULTON ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 273-8383

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 Nuttavut Sumransub's NPI number?

The NPI number for Nuttavut Sumransub is 1003470568. It was assigned to this individual provider in the NPPES registry on April 30, 2019.

Where is Nuttavut Sumransub located?

Nuttavut Sumransub practices at 909 Fulton St SE, Minneapolis, MN 55455. The listed phone number is (612) 672-7422.

What is Nuttavut Sumransub's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Is Nuttavut Sumransub enrolled in Medicare?

Yes. Nuttavut Sumransub is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nuttavut Sumransub was last updated on July 20, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.