DR. SOHAIL H ALI M.D.
NPI 1235137167
Internal Medicine - Endocrinology, Diabetes & Metabolism in Maitland, FL

Active since July 13, 2005PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
635 N MAITLAND AVE, MAITLAND, FL 32751(407) 629-4901(407) 629-0168 Get Directions Write a Review

NPPES record last updated: July 16, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Sohail H Ali M.d. NPPES

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

DR. SOHAIL H ALI M.D. (NPI 1235137167) is an individual endocrinology, diabetes & metabolism provider in Maitland, Florida, licensed in Florida (ME78518) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Orlando Health, and is a graduate of Other (1983).

NPPES Registry Identity

NPI1235137167
Entity TypeIndividualMale
Primary Taxonomy207RE0101X
Provider Legal NameDR. SOHAIL H ALICredential: M.D.
Location Address635 N MAITLAND AVEMaitland, FL 32751-4422
Mailing Address635 N Maitland AveMaitland, FL 32751-4422 · (407) 629-4901 · Fax (407) 629-0168
Fax(407) 629-0168
Sole ProprietorNo
Medical School CMSOtherGraduated 1983
Enumeration DateJuly 13, 2005
Last NPPES UpdateJuly 16, 2013
NPI 1235137167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License Licensed in FL · ME78518
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
635 N MAITLAND AVE, Maitland, FL 32751

Other Identifiers 1

Medicare PIN47066ZFL

Accepted 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. Sohail H 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 ID2264596055
PECOS Enrollment IDI20090122000395
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 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.

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.
1,234 services612 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
547 services227 patients
Ultrasound scan of head and neck soft tissue 76536
An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.
184 services168 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.
156 services156 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.
145 services123 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.
124 services97 patients

Hospital Affiliations CMS Care Compare 4

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

Orlando Health

Acute Care Hospitals · Orlando, FL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100006
Location52 W Underwood StOrlando, FL 32806 · Orange County
Emergency services Birthing friendly

Adventhealth Orlando

Acute Care Hospitals · Orlando, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100007
Location601 E Rollins StOrlando, FL 32803 · Orange County
Emergency services Birthing friendly

Orlando Health-Health Central Hospital

Acute Care Hospitals · Ocoee, FL
2/5 CMS rating
OwnershipGovernment - State
CMS Certification Number100030
Location10000 W Colonial DrOcoee, FL 34761 · Orange County
Emergency services

Adventhealth Deland

Acute Care Hospitals · Deland, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number100045
Location701 W Plymouth AveDeland, FL 32720 · Volusia County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32751 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored

Reported Quality Measures

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
73%727 patients3/55-star benchmark: 100%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
76%727 patients4/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%4,854 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
70%1,408 patients3/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%108 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
16%1,069 patients1/55-star benchmark: 99%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
69%2,143 patients3/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
82%1,069 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
70%1,069 patients5/55-star benchmark: 59%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 842 patients
1%842 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

Supplies for maintenance of insulin infusion catheter, per week A4224
DME-Other DME · category DE017N
6 suppliers45 claims570 services$18.20 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
6 suppliers43 claims1,428 services$2.36 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
64 suppliers188 claims721 services$6.41 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
3 suppliers18 claims18 services$2.93 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
29 suppliers75 claims172 services$1.15 avg. paid by Medicare
External ambulatory infusion pump, insulin E0784
DME-Other DME · category DE017N
4 suppliers20 claims20 services$294.67 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 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine (Endocrinology, Diabetes & Metabolism)
635 N MAITLAND AVE
MAITLAND, FL 32751
Internal Medicine (Endocrinology, Diabetes & Metabolism)
635 N MAITLAND AVE
MAITLAND, FL 32751
Internal Medicine (Endocrinology, Diabetes & Metabolism)
635 N MAITLAND AVE
MAITLAND, FL 32751
Internal Medicine (Endocrinology, Diabetes & Metabolism)
635 N MAITLAND AVE
MAITLAND, FL 32751
Internal Medicine (Endocrinology, Diabetes & Metabolism)
635 N MAITLAND AVE
MAITLAND, FL 32751
Physician Assistant (Medical)
635 N MAITLAND AVE
MAITLAND, FL 32751
Internal Medicine (Endocrinology, Diabetes & Metabolism)
635 N MAITLAND AVE
MAITLAND, FL 32751

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 Sohail Ali's NPI number?

The NPI number for Sohail Ali is 1235137167. It was assigned to this individual provider in the NPPES registry on July 13, 2005.

Where is Sohail Ali located?

Sohail Ali practices at 635 N Maitland Ave, Maitland, FL 32751. The listed phone number is (407) 629-4901.

What is Sohail Ali's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Sohail Ali enrolled in Medicare?

Yes. Sohail 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.

What insurance does Sohail Ali accept?

Health plans from AvMed and Florida Health Care Plans list Sohail Ali 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 Sohail Ali affiliated with any hospitals?

According to CMS data, Sohail Ali is affiliated with Orlando Health, Adventhealth Orlando, Orlando Health-Health Central Hospital and Adventhealth Deland.

When was this NPI record last updated?

The NPPES record for Sohail Ali was last updated on July 16, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.