SUMATHA GHANTA MD
NPI 1053548156
Family Medicine in Monroe, LA
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
Specialties & Licenses 2
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
2Medicare enrollment records show Sumatha Ghanta reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Monroe, LA 71201
- Reassigned Medicare billing, Louisiana enrollment
- 156 clinicians in this Medicare group
Baton Rouge, LA 70808
- Reassigned Medicare billing, Louisiana enrollment
- 371 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
St Francis Medical Center
Acute Care Hospitals · Monroe, LAMonroe Surgical Hospital
Acute Care Hospitals · Monroe, LAPhysician 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.
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.
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.
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.
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.
Which organizations bill Medicare for Sumatha Ghanta's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Sumatha Ghanta reassigns Medicare benefits to 2 organizations: Affinity Health Group LLC (Monroe, LA) and Baton Rouge Clinic, A Medical Corporation (Baton Rouge, LA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sumatha Ghanta's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Sumatha Ghanta accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, 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 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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Sumatha Ghanta, MD · NPI 1053548156
Family Medicine physician in Monroe, Louisiana. Individual provider, active in the CMS NPPES registry since June 16, 2009.
## Identity
- **NPI:** 1053548156 (Entity type: Individual)
- **Enumerated:** June 16, 2009
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** MD205575 (Louisiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 920 OLIVER RD, Monroe, LA 71201-5702
- **Phone:** (318) 807-3700 · **Fax:** (318) 807-0014
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Affinity Health Group LLC (NPI 1053957944, Monroe, LA); Baton Rouge Clinic, A Medical Corporation (NPI 1871546911, Baton Rouge, LA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2003
## Record status
- **NPPES last updated:** June 11, 2019
- **Other identifiers:** Medicaid 1929735 (LA)
---
Source: [NPI Profile](https://npiprofile.com/npi/1053548156) · Data from the CMS NPPES public registry.