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DR. FADWA SUMREIN D.O
NPI 1043637192
Internal Medicine - Endocrinology, Diabetes & Metabolism in Clifton, NJ

Active since March 26, 2014PECOS EnrolledAccepts Medicare Assignment
94.95/100
CMS Quality Rating
2 BRIGHTON RD STE 400, CLIFTON, NJ 07012(862) 297-9696(862) 297-9695 Get Directions Write a Review

NPPES record last updated: November 25, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Fadwa Sumrein D.o NPPES

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

DR. FADWA SUMREIN D.O (NPI 1043637192) is an individual endocrinology, diabetes & metabolism provider in Clifton, New Jersey, licensed in New Jersey (25MB10591700) and active in the NPI registry since March 2014. She is enrolled in Medicare PECOS, is affiliated with St Mary's General Hospital, and maintains a secondary practice location in Clifton.

NPPES Registry Identity

NPI1043637192
Entity TypeIndividualFemale
Primary Taxonomy207RE0101X
Provider Legal NameDR. FADWA SUMREINCredential: D.O
Location Address2 BRIGHTON RD STE 400Clifton, NJ 07012
Mailing Address2 Brighton Rd Ste 400Clifton, NJ 07012-1670 · (862) 297-9696 · Fax (862) 297-9695
Phone(862) 297-9696
Fax(862) 297-9695
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateMarch 26, 2014
Last NPPES UpdateNovember 25, 2019
✔ NPI 1043637192 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in NJ · 25MB10591700
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
2 BRIGHTON RD STE 400, Clifton, NJ 07012
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Secondary Practice Location 1

Location 12 Brighton Rd Ste 400Clifton, NJ 07012 · Phone (862) 297-9696 · Fax (862) 297-9695

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.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. Fadwa Sumrein D.o 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 ID648509398
PECOS Enrollment IDI20190906000104
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 7

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.

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.
655 services282 patients
Blood glucose (sugar) test performed by hand-held instrument 82962
A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.
177 services109 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
143 services66 patients
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.
128 services23 patients
Blood glucose (sugar) level 82947
A blood glucose level test measures the amount of sugar in your blood. It's often used to monitor and manage conditions like diabetes. High or low levels can indicate a health issue. The test is usually done by pricking your finger for a small blood sample.
64 services58 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.
44 services44 patients

Hospital Affiliations CMS Care Compare 3

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

St Mary's General Hospital

Acute Care Hospitals · Passaic, NJ
3/5 CMS rating
OwnershipProprietary
CMS Certification Number310006
Location350 BoulevardPassaic, NJ 07055 · Passaic County
Emergency services Birthing friendly

St Joseph's University Medical Center Inc

Acute Care Hospitals · Paterson, NJ
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number310019
Location703 Main StPaterson, NJ 07503 · Passaic County
Birthing friendly

Englewood Hospital And Medical Center

Acute Care Hospitals · Englewood, NJ
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310045
Location350 Engle StEnglewood, NJ 07631 · Bergen County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07012 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
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
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.

94.95/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality87.26
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
20 suppliers59 claims141 services$6.43 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
9 suppliers29 claims39 services$1.14 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
8 suppliers123 claims126 services$190.35 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

DR. AJAY GUPTA M.D.
Internal Medicine (Interventional Cardiology)
2 BRIGHTON RD STE 400
CLIFTON, NJ 07012
Passaic County (862) 249-4904
SYLVIA ESHAK WILLIAM ESHAK MD
Family Medicine
2 BRIGHTON RD STE 400
CLIFTON, NJ 07012
Passaic County (862) 249-4904

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 Fadwa Sumrein's NPI number?

The NPI number for Fadwa Sumrein is 1043637192. It was assigned to this individual provider in the NPPES registry on March 26, 2014.

Where is Fadwa Sumrein located?

Fadwa Sumrein practices at 2 Brighton Rd Ste 400, Clifton, NJ 07012. The listed phone number is (862) 297-9696.

What is Fadwa Sumrein's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Fadwa Sumrein enrolled in Medicare?

Yes. Fadwa Sumrein 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 Fadwa Sumrein accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Fadwa Sumrein 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 Fadwa Sumrein affiliated with any hospitals?

According to CMS data, Fadwa Sumrein is affiliated with St Mary's General Hospital, St Joseph's University Medical Center Inc and Englewood Hospital And Medical Center.

When was this NPI record last updated?

The NPPES record for Fadwa Sumrein was last updated on November 25, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.