DR. MARK SEAN SUMIDA MD
NPI 1093764037
Orthopaedic Surgery in Hixson, TN

Q: What is Mark Sumida's NPI number?

The NPI number for Mark Sumida is 1093764037. It was assigned to this individual provider in the NPPES registry on May 8, 2006.

Q: What is Mark Sumida's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Mark Sumida was last updated on February 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since May 08, 2006PECOS EnrolledAccepts Medicare Assignment

1724 HAMILL ROAD SUITE 204, HIXSON, TN 37343(423) 877-4705(423) 877-9970 Get Directions Write a Review

NPPES record last updated: February 20, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 20, 2023, Jun 6, 2017 (2 updates tracked since 2017).

On this page

About Dr. Mark Sean Sumida Md NPPES

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

DR. MARK SEAN SUMIDA MD (NPI 1093764037) is an individual orthopaedic surgery provider in Hixson, Tennessee, licensed in Tennessee (20177) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Memorial Healthcare System, Inc, and is a graduate of University Of Kentucky College Of Medicine (1988).

NPPES Registry Identity

NPI1093764037

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. MARK SEAN SUMIDACredential: MD

Location Address1724 HAMILL ROAD SUITE 204Hixson, TN 37343

Mailing Address3024 Business Park CirGoodlettsville, TN 37072-3132 · (615) 239-2018

Phone(423) 877-4705

Fax(423) 877-9970

Sole ProprietorNo

Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 1988

Enumeration DateMay 8, 2006

Last NPPES UpdateFebruary 20, 20232 updates tracked since enumeration

NPPES CertifiedFebruary 20, 2023

✔ NPI 1093764037 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in TN · 20177

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

1724 HAMILL ROAD SUITE 204, Hixson, TN 37343

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and more.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. Mark Sean Sumida 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 ID4587616818

PECOS Enrollment IDI20100818000781

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 14

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

1,968 services184 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

492 services271 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

389 services177 patients

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.

342 services205 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

252 services172 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

104 services79 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

90 services52 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.

63 services63 patients

X-ray of ankle, minimum of 3 views 73610

An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.

48 services29 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

42 services42 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

41 services35 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

39 services31 patients

Aspiration and/or injection of fluid from medium joint 20605

This procedure involves a needle being inserted into a medium-sized joint, such as a knee or shoulder, to remove (aspirate) excess fluid. Sometimes, medication may also be injected into the joint to reduce inflammation and pain.

20 services13 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

15 services15 patients

Hospital Affiliations CMS Care Compare

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

Memorial Healthcare System, Inc

Acute Care Hospitals · Chattanooga, TN

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number440091

Location2525 Desales AveChattanooga, TN 37404 · Hamilton County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37343 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

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

1 supplier13 claims13 services$18.16 avg. paid by Medicare

Knee orthosis, elastic with joints, prefabricated, off-the-shelf L1812

DME-Orthotic Devices · category DF011N

1 supplier18 claims18 services$53.92 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Mark Sumida's NPI number?

The NPI number for Mark Sumida is 1093764037. It was assigned to this individual provider in the NPPES registry on May 8, 2006.

Where is Mark Sumida located?

Mark Sumida practices at 1724 Hamill Road Suite 204, Hixson, TN 37343. The listed phone number is (423) 877-4705.

What is Mark Sumida's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Mark Sumida enrolled in Medicare?

Yes. Mark Sumida 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 Mark Sumida accept?

Health plans from Alliant Health Plans, Inc., Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health and Ambetter of Alabama and 5 other insurers list Mark Sumida 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 Mark Sumida affiliated with any hospitals?

According to CMS data, Mark Sumida is affiliated with Memorial Healthcare System, Inc.

When was this NPI record last updated?

The NPPES record for Mark Sumida was last updated on February 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.