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SUMAIRA ALI M.D
NPI 1164857462
Internal Medicine in Hagerstown, MD

Active since September 05, 2013PECOS EnrolledAccepts Medicare Assignment
11116 MEDICAL CAMPUS RD, HAGERSTOWN, MD 21742(301) 790-8804 Get Directions Write a Review

NPPES record last updated: January 30, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Sumaira Ali M.d NPPES

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

SUMAIRA ALI M.D (NPI 1164857462) is an individual internal medicine provider in Hagerstown, Maryland, licensed in Maryland (D96040) and active in the NPI registry since September 2013. She is enrolled in Medicare PECOS, is affiliated with Meritus Medical Center, and maintains a secondary practice location in Cincinnati.

NPPES Registry Identity

NPI1164857462
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameSUMAIRA ALICredential: M.D
Location Address11116 MEDICAL CAMPUS RDHagerstown, MD 21742-6710
Mailing Address5129 Sante Fe CtEllicott City, MD 21043-8019
Phone(301) 790-8804
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateSeptember 5, 2013
Last NPPES UpdateJanuary 30, 2023
NPPES CertifiedJanuary 30, 2023
✔ NPI 1164857462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in MD · D96040✔ Licensed in OH · 57.022732
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
11116 MEDICAL CAMPUS RD, Hagerstown, MD 21742
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Secondary Practice Location 1

Location 14777 E Galbraith RdCincinnati, OH 45236-2725 · Phone (513) 686-5446 · Fax (513) 686-5443

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

Sumaira Ali M.d 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 ID9931497989
PECOS Enrollment IDI20230211000063
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 4

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.

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.
577 services318 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
230 services222 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
104 services103 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
35 services27 patients

Hospital Affiliations CMS Care Compare

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

Meritus Medical Center

Acute Care Hospitals · Hagerstown, MD
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number210001
Location11116 Medical Campus RoadHagerstown, MD 21742 · Washington County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21742 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
$133.05 typical visit price
range $57.99 – $175.57
Typical copayment $33.26 (range $14.49 – $43.89)
Most-billed visit code 99204
Established Patient
$102.11 typical visit price
range $18.66 – $143.02
Typical copayment $25.52 (range $4.66 – $35.75)
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.

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.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers26 claims26 services$14.35 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
2 suppliers26 claims26 services$77.04 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.

ALLEN L TWIGG LCPC
Counselor (Professional)
11116 MEDICAL CAMPUS RD
HAGERSTOWN, MD 21742
Washington County (301) 766-7600
MS. PATTI KAY COOPER LCSW-C
Social Worker (Clinical)
11116 MEDICAL CAMPUS RD, SUITE 2989
HAGERSTOWN, MD 21742
Washington County (301) 766-7600
TARA BAKER
Nurse Practitioner (Family)
11116 MEDICAL CAMPUS RD
HAGERSTOWN, MD 21742
Washington County (301) 667-0041
RACHEL ANNE KNICLEY MS, LAT, ATC
Specialist/Technologist (Athletic Trainer)
11116 MEDICAL CAMPUS RD
HAGERSTOWN, MD 21742
Washington County (301) 491-2332
ERIKA SPINKS FNP
Nurse Practitioner
11116 MEDICAL CAMPUS RD
HAGERSTOWN, MD 21742
Washington County (301) 790-8000
HELMSON B LOUISDOR DO
Student in an Organized Health Care Education/Training Program
11116 MEDICAL CAMPUS RD
HAGERSTOWN, MD 21742
Washington County (240) 313-9554
MRS. JUDITH ANNE STAMBAUGH FNP-BC
Nurse Practitioner (Family)
11116 MEDICAL CAMPUS RD
HAGERSTOWN, MD 21742
Washington County (301) 790-8804
ERIN STRASSER PA-C
Physician Assistant
11116 MEDICAL CAMPUS RD
HAGERSTOWN, MD 21742
Washington County (301) 790-8000

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 Sumaira Ali's NPI number?

The NPI number for Sumaira Ali is 1164857462. It was assigned to this individual provider in the NPPES registry on September 5, 2013.

Where is Sumaira Ali located?

Sumaira Ali practices at 11116 Medical Campus Rd, Hagerstown, MD 21742. The listed phone number is (301) 790-8804.

What is Sumaira Ali's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Sumaira Ali enrolled in Medicare?

Yes. Sumaira Ali 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.

Is Sumaira Ali affiliated with any hospitals?

According to CMS data, Sumaira Ali is affiliated with Meritus Medical Center.

When was this NPI record last updated?

The NPPES record for Sumaira Ali was last updated on January 30, 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.