SUMATHA GHANTA MD
NPI 1053548156
Family Medicine in Monroe, LA

Active since June 16, 2009PECOS EnrolledAccepts Medicare Assignment
78.33/100
CMS Quality Rating
920 OLIVER RD, MONROE, LA 71201(318) 807-3700(318) 807-0014 Get Directions Write a Review

NPPES record last updated: June 11, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 11, 2019, Feb 24, 2017, Jan 15, 2016 (3 updates tracked since 2016).

About Sumatha Ghanta Md NPPES

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

SUMATHA GHANTA MD (NPI 1053548156) is an individual family medicine provider in Monroe, Louisiana, licensed in Louisiana (MD205575) and active in the NPI registry since June 2009. She is enrolled in Medicare PECOS, is affiliated with St Francis Medical Center, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1053548156
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameSUMATHA GHANTACredential: MD
Location Address920 OLIVER RDMonroe, LA 71201-5702
Mailing Address130 Desiard St, Suite 355Monroe, LA 71201-7319 · (318) 807-7875 · Fax (318) 812-6603
Fax(318) 807-0014
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateJune 16, 2009
Last NPPES UpdateJune 11, 20193 updates tracked since enumeration
NPI 1053548156 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in LA · MD205575
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

920 OLIVER RD, Monroe, LA 71201

Other Identifiers 1

Medicaid1929735LA

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

Sumatha Ghanta 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 ID648426536
PECOS Enrollment IDI20120808000714
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 20

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.
412 services127 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
141 services107 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
126 services107 patients
Blood test, thyroid stimulating hormone (tsh) 84443
A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.
122 services101 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
116 services51 patients
Blood test, lipids (cholesterol and triglycerides) 80061
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
109 services100 patients

Hospital Affiliations CMS Care Compare 3

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

St Francis Medical Center

Acute Care Hospitals · Monroe, LA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number190125
Location309 Jackson StreetMonroe, LA 71201 · Ouachita County
Emergency services Birthing friendly

Glenwood Regional Medical Center

Acute Care Hospitals · West Monroe, LA
1/5 CMS rating
OwnershipProprietary
CMS Certification Number190160
Location503 Mcmillan RoadWest Monroe, LA 71291 · Ouachita County
Emergency services

Monroe Surgical Hospital

Acute Care Hospitals · Monroe, LA
OwnershipProprietary
CMS Certification Number190245
Location2408 Broadmoor BlvdMonroe, LA 71201 · Ouachita County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 71201 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
$83.60 typical visit price
range $53.43 – $164.73
Typical copayment $20.90 (range $13.35 – $41.18)
Most-billed visit code 99203
Established Patient
$95.09 typical visit price
range $16.64 – $133.62
Typical copayment $23.77 (range $4.16 – $33.40)
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.

78.33/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality54.65
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 8

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
9 suppliers28 claims72 services$6.67 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers13 claims18 services$1.16 avg. paid by Medicare
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each A4409
DME-Orthotic Devices · category DF010N
1 supplier15 claims300 services$5.30 avg. paid by Medicare
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each A4425
DME-Orthotic Devices · category DF010N
1 supplier12 claims240 services$3.46 avg. paid by Medicare
Skin barrier, wipes or swabs, each A5120
DME-Orthotic Devices · category DF010N
1 supplier15 claims400 services$0.19 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier24 claims25 services$87.85 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 20

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

Family Medicine
920 OLIVER RD, SUITE C
MONROE, LA 71201
Pediatrics
920 OLIVER RD, SUITE 3
MONROE, LA 71201
Nurse Practitioner (Gerontology)
920 OLIVER RD
MONROE, LA 71201
Nurse Practitioner (Family)
920 OLIVER RD, SUITE 600
MONROE, LA 71201
Nurse Practitioner (Family)
920 OLIVER RD
MONROE, LA 71201
Clinic/Center (Hearing and Speech)
920 OLIVER RD
MONROE, LA 71201
Family Medicine
920 OLIVER RD
MONROE, LA 71201
Specialist
920 OLIVER RD, SUITE 1475
MONROE, LA 71201

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 Sumatha Ghanta's NPI number?

The NPI number for Sumatha Ghanta is 1053548156. It was assigned to this individual provider in the NPPES registry on June 16, 2009.

Where is Sumatha Ghanta located?

Sumatha Ghanta practices at 920 Oliver Rd, Monroe, LA 71201. The listed phone number is (318) 807-3700.

What is Sumatha Ghanta's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sumatha Ghanta enrolled in Medicare?

Yes. Sumatha Ghanta 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 Sumatha Ghanta accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter from Superior HealthPlan and Blue Cross and Blue Shield of Louisiana and 2 other insurers list Sumatha Ghanta 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 Sumatha Ghanta affiliated with any hospitals?

According to CMS data, Sumatha Ghanta is affiliated with St Francis Medical Center, Glenwood Regional Medical Center and Monroe Surgical Hospital.

When was this NPI record last updated?

The NPPES record for Sumatha Ghanta was last updated on June 11, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.