SUMIT SITOLE M.D.
NPI 1205088507
Ophthalmology in Denver, CO
About Sumit Sitole M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SUMIT SITOLE M.D. (NPI 1205088507) is an individual ophthalmology provider in Denver, Colorado, licensed in Maryland (D67988) and active in the NPI registry since October 2008. He is enrolled in Medicare PECOS and is a graduate of Tufts University School Of Medicine (2004).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
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
Sumit Sitole 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.
Medicare Billing Reassignment
Medicare enrollment records show Sumit Sitole reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Denver, CO 80222
- Reassigned Medicare billing, Colorado enrollment
- 2 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 9
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 80206 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.
Reported Quality Measures
Other Providers at the Same Location NPPES 17
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
DENVER, CO 80206
DENVER, CO 80206
DENVER, CO 80206
DENVER, CO 80206
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 Sumit Sitole's NPI number?
The NPI number for Sumit Sitole is 1205088507. It was assigned to this individual provider in the NPPES registry on October 17, 2008.
Where is Sumit Sitole located?
Sumit Sitole practices at 55 Madison St 355, Denver, CO 80206. The listed phone number is (303) 377-2020.
What is Sumit Sitole's specialty?
The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.
Is Sumit Sitole enrolled in Medicare?
Yes. Sumit Sitole 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 organization bills Medicare for Sumit Sitole's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Sumit Sitole reassigns Medicare benefits to Denver Oculoplastics (Denver, CO). The 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 Sumit Sitole's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Sumit Sitole accept?
Health plans from UnitedHealthcare list Sumit Sitole 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.
When was this NPI record last updated?
The NPPES record for Sumit Sitole was last updated on September 10, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Sumit Sitole, M.D. · NPI 1205088507
Ophthalmology physician in Denver, Colorado. Individual provider, active in the CMS NPPES registry since October 17, 2008.
## Identity
- **NPI:** 1205088507 (Entity type: Individual)
- **Enumerated:** October 17, 2008
- **Primary specialty:** Ophthalmology · taxonomy 207W00000X
- **State license:** D67988 (Maryland)
- **Sole proprietor:** No
## Practice location
- **Address:** 55 MADISON ST, 355, Denver, CO 80206-5419
- **Phone:** (303) 377-2020 · **Fax:** (303) 388-0606
## 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:** Denver Oculoplastics (NPI 1790340537, Denver, CO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Tufts University School Of Medicine, class of 2004
## Record status
- **NPPES last updated:** September 10, 2012
- **Other identifiers:** Medicaid 84034785 (CO); Other 49102 (CO); Medicare PIN S572 (MD)
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Source: [NPI Profile](https://npiprofile.com/npi/1205088507) · Data from the CMS NPPES public registry.