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CYNTHIA L SUMNER MD
NPI 1235181884
Internal Medicine in Fort Gaines, GA

Active since May 16, 2006PECOS EnrolledAccepts Medicare Assignment
78.41/100
CMS Quality Rating
101 HARTFORD RD W STE 1, FORT GAINES, GA 39851(229) 210-2100 Get Directions Write a Review

NPPES record last updated: March 22, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Cynthia L Sumner Md NPPES

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

CYNTHIA L SUMNER MD (NPI 1235181884) is an individual internal medicine provider in Fort Gaines, Georgia, licensed in Georgia (57685) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Phoebe Putney Memorial Hospital, and is a graduate of Mercer University School Of Medicine (2006).

NPPES Registry Identity

NPI1235181884
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameCYNTHIA L SUMNERCredential: MD
Location Address101 HARTFORD RD W STE 1Fort Gaines, GA 39851-4331
Mailing Address250 Martin Luther King Jr BlvdMacon, GA 31201-3490
Phone(229) 210-2100
Sole ProprietorNo
Medical School CMSMercer University School Of MedicineGraduated 2006
Enumeration DateMay 16, 2006
Last NPPES UpdateMarch 22, 2024
NPPES CertifiedMarch 22, 2024
✔ NPI 1235181884 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in GA · 57685
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.
101 HARTFORD RD W STE 1, Fort Gaines, GA 39851
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter 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

Cynthia L Sumner 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 ID4981615127
PECOS Enrollment IDI20060601000012
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 7

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.
313 services198 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
63 services62 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
56 services56 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
28 services28 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
16 services12 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
16 services16 patients

Hospital Affiliations CMS Care Compare 5

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

Phoebe Putney Memorial Hospital

Acute Care Hospitals · Albany, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110007
Location417 Third AvenueAlbany, GA 31703 · Dougherty County
Emergency services Birthing friendly

Phoebe Sumter Medical Center

Acute Care Hospitals · Americus, GA
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110044
Location126 Highway 280 WAmericus, GA 31719 · Sumter County
Emergency services Birthing friendly

Tift Regional Medical Center

Acute Care Hospitals · Tifton, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110095
Location901 E 18th StreetTifton, GA 31793 · Tift County
Emergency services Birthing friendly

Crisp Regional Hospital

Acute Care Hospitals · Cordele, GA
3/5 CMS rating
OwnershipProprietary
CMS Certification Number110104
Location902 7th Street NorthCordele, GA 31015 · Crisp County
Emergency services Birthing friendly

Colquitt Regional Medical Center

Acute Care Hospitals · Moultrie, GA
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110105
Location3131 South Main StreetMoultrie, GA 31768 · Colquitt County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39851 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

78.41/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality58.68
Promoting Interoperability100
Improvement Activities40
Cost66.15

Referred Medical Equipment & Supplies CMS DME claims 21

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
11 suppliers83 claims196 services$6.17 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
8 suppliers26 claims32 services$1.13 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
4 suppliers13 claims13 services$44.97 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
9 suppliers41 claims41 services$110.18 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
7 suppliers44 claims123 services$40.39 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
5 suppliers40 claims221 services$22.12 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

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

JENNIFER SANDERS PA-C
Physician Assistant
101 HARTFORD RD W STE 1
FORT GAINES, GA 39851
Clay County (229) 210-2100

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 Cynthia Sumner's NPI number?

The NPI number for Cynthia Sumner is 1235181884. It was assigned to this individual provider in the NPPES registry on May 16, 2006.

Where is Cynthia Sumner located?

Cynthia Sumner practices at 101 Hartford Rd W Ste 1, Fort Gaines, GA 39851. The listed phone number is (229) 210-2100.

What is Cynthia Sumner's specialty?

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

Is Cynthia Sumner enrolled in Medicare?

Yes. Cynthia Sumner 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 Cynthia Sumner accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Cynthia Sumner 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 Cynthia Sumner affiliated with any hospitals?

According to CMS data, Cynthia Sumner is affiliated with Phoebe Putney Memorial Hospital, Phoebe Sumter Medical Center, Tift Regional Medical Center, Crisp Regional Hospital and Colquitt Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Cynthia Sumner was last updated on March 22, 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.