TWYLLA RENE COX-SUGIMOTO MD
NPI 1245342864
Family Medicine in Merced, CA

Active since August 31, 2006PECOS EnrolledAccepts Medicare Assignment
96.5/100
CMS Quality Rating
3393 G ST STE C, MERCED, CA 95340(209) 580-4172(209) 233-9859 Get Directions Write a Review

NPPES record last updated: December 10, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 10, 2020, Dec 19, 2019 (2 updates tracked since 2019).

About Twylla Rene Cox-sugimoto Md NPPES

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

TWYLLA RENE COX-SUGIMOTO MD (NPI 1245342864) is an individual family medicine provider in Merced, California, licensed in California (G77505) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS and is a graduate of University Of Nevada School Of Medicine (1992).

NPPES Registry Identity

NPI1245342864
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameTWYLLA RENE COX-SUGIMOTOCredential: MD
Location Address3393 G ST STE CMerced, CA 95340-1001
Mailing AddressPo Box 3768Merced, CA 95344-3768 · (209) 725-7149 · Fax (209) 726-0134
Fax(209) 233-9859
Sole ProprietorNo
Medical School CMSUniversity Of Nevada School Of MedicineGraduated 1992
Enumeration DateAugust 31, 2006
Last NPPES UpdateDecember 10, 20202 updates tracked since enumeration
NPPES CertifiedDecember 10, 2020
NPI 1245342864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in CA · G77505
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3393 G ST STE C, Merced, CA 95340

Other Identifiers 1

Medicaid00G775050CA

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

Twylla Rene Cox-sugimoto 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 ID8921170457
PECOS Enrollment IDI20080627000526
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.

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.
37 services16 patients
Annual alcohol misuse screening, 5 to 15 minutes G0442
An annual alcohol misuse screening is a 15-minute check-up to assess your drinking habits. It helps identify if you're consuming alcohol in a way that could harm your health. This is not a judgment, but a tool to promote your wellbeing.
13 services13 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
13 services13 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.
11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95340 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
$90.32 typical visit price
range $58.87 – $176.60
Typical copayment $22.58 (range $14.71 – $44.15)
Most-billed visit code 99203
Established Patient
$103.36 typical visit price
range $19.28 – $144.60
Typical copayment $25.84 (range $4.82 – $36.15)
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.

96.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.34
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
84%32 patients4/55-star benchmark: 92%
Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
92%25 patients4/55-star benchmark: 100%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
87%70 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
75%36 patients4/55-star benchmark: 85%
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%260 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.
98%450 patients4/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
81%21 patients4/55-star benchmark: 99%
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.
93%152 patients4/55-star benchmark: 97%
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…
44%108 patients2/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 82 patients
96%82 patients4/55-star benchmark: 98%
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…
100%152 patients5/55-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…
7%152 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
32%152 patients
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.

Other Providers at the Same Location NPPES 6

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

Nurse Practitioner (Pediatrics)
3393 G ST STE C
MERCED, CA 95340
Family Medicine
3393 G ST STE C
MERCED, CA 95340
Nurse Practitioner (Family)
3393 G ST STE C
MERCED, CA 95340
Family Medicine
3393 G ST STE C
MERCED, CA 95340
Nurse Practitioner (Family)
3393 G ST STE C
MERCED, CA 95340
Family Medicine
3393 G ST STE C
MERCED, CA 95340

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 Twylla Cox-sugimoto's NPI number?

The NPI number for Twylla Cox-sugimoto is 1245342864. It was assigned to this individual provider in the NPPES registry on August 31, 2006.

Where is Twylla Cox-sugimoto located?

Twylla Cox-sugimoto practices at 3393 G St Ste C, Merced, CA 95340. The listed phone number is (209) 580-4172.

What is Twylla Cox-sugimoto's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Twylla Cox-sugimoto enrolled in Medicare?

Yes. Twylla Cox-sugimoto 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.

When was this NPI record last updated?

The NPPES record for Twylla Cox-sugimoto was last updated on December 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.