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SUMAN RAJ SAPKOTA MD
NPI 1215500277
Internal Medicine in Florence, AL

Active since July 19, 2021PECOS EnrolledAccepts Medicare Assignment
1701 VETERANS DR, FLORENCE, AL 35630(256) 629-1950 Get Directions Write a Review

NPPES record last updated: May 9, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 9, 2024, Jul 19, 2021 (2 updates tracked since 2021).

About Suman Raj Sapkota Md NPPES

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

SUMAN RAJ SAPKOTA MD (NPI 1215500277) is an individual internal medicine provider in Florence, Alabama, licensed in Alabama (L.5599R) and active in the NPI registry since July 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1215500277
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameSUMAN RAJ SAPKOTACredential: MD
Location Address1701 VETERANS DRFlorence, AL 35630-4928
Mailing Address1701 Veterans DrFlorence, AL 35630-4928 · (256) 629-1950
Phone(256) 629-1950
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateJuly 19, 2021
Last NPPES UpdateMay 9, 20242 updates tracked since enumeration
NPPES CertifiedMay 9, 2024
✔ NPI 1215500277 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in AL · L.5599R
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.
1701 VETERANS DR, Florence, AL 35630
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama.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

Suman Raj Sapkota 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 ID9133560642
PECOS Enrollment IDI20240515002477
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 3

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.
210 services84 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
59 services59 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.
39 services39 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35630 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
$122.31 typical visit price
range $52.65 – $161.63
Typical copayment $30.57 (range $13.16 – $40.40)
Most-billed visit code 99204
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
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.

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.

CAMERON PATRICK HENDERSON
Nurse Practitioner (Acute Care)
1701 VETERANS DR
FLORENCE, AL 35630
Lauderdale County (256) 629-1000
RITIKA KUMAR
Internal Medicine
1701 VETERANS DR
FLORENCE, AL 35630
Lauderdale County (256) 629-1950
USBAH KHALID
Internal Medicine
1701 VETERANS DR
FLORENCE, AL 35630
Lauderdale County (256) 629-1000
KARLEY ELIZABETH FLORES PA
Physician Assistant
1701 VETERANS DR
FLORENCE, AL 35630
Lauderdale County (256) 629-1000
DR. DEMILADE ADEAYO SOJI-AYOADE MD
Student in an Organized Health Care Education/Training Program
1701 VETERANS DR
FLORENCE, AL 35630
Lauderdale County (256) 629-1950
SARAH MAHMOUD ATIA ELSAYED MD
Internal Medicine
1701 VETERANS DR
FLORENCE, AL 35630
Lauderdale County (256) 629-1950
BRITTANY NICOLE STINNETT
Nurse Anesthetist, Certified Registered
1701 VETERANS DR
FLORENCE, AL 35630
Lauderdale County (256) 629-1000
SARMAD ZAIN MD
Student in an Organized Health Care Education/Training Program
1701 VETERANS DR
FLORENCE, AL 35630
Lauderdale County (256) 629-1950

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 Suman Sapkota's NPI number?

The NPI number for Suman Sapkota is 1215500277. It was assigned to this individual provider in the NPPES registry on July 19, 2021.

Where is Suman Sapkota located?

Suman Sapkota practices at 1701 Veterans Dr, Florence, AL 35630. The listed phone number is (256) 629-1950.

What is Suman Sapkota's specialty?

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

Is Suman Sapkota enrolled in Medicare?

Yes. Suman Sapkota 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 Suman Sapkota accept?

Health plans from Blue Cross and Blue Shield of Alabama list Suman Sapkota 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 Suman Sapkota was last updated on May 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.