DR. JAYA PRAKASH SUGUNARAJ M.D
NPI 1255647673
Internal Medicine - Pulmonary Disease in Carmel, CA

Q: What is Jaya Prakash Sugunaraj's NPI number?

The NPI number for Jaya Prakash Sugunaraj is 1255647673. It was assigned to this individual provider in the NPPES registry on August 23, 2010.

Q: What is Jaya Prakash Sugunaraj's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Active since August 23, 2010PECOS EnrolledAccepts Medicare Assignment

275 THE CROSSROADS BLVD STE A, CARMEL, CA 93923(831) 718-9701 Get Directions Write a Review

NPPES record last updated: August 30, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 30, 2022, Aug 26, 2020, Jul 31, 2020 and 1 more (4 updates tracked since 2017).

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About Dr. Jaya Prakash Sugunaraj M.d NPPES

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

DR. JAYA PRAKASH SUGUNARAJ M.D (NPI 1255647673) is an individual pulmonary disease provider in Carmel, California, licensed in California (C169256) and active in the NPI registry since August 2010. He is enrolled in Medicare PECOS and is a graduate of Other (2005).

NPPES Registry Identity

NPI1255647673

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameDR. JAYA PRAKASH SUGUNARAJCredential: M.D

Location Address275 THE CROSSROADS BLVD STE ACarmel, CA 93923-8685

Mailing Address100 Wilson Rd Ste 100Monterey, CA 93940-7885 · (831) 649-1000

Phone(831) 718-9701

Sole ProprietorNo

Medical School CMSOtherGraduated 2005

Enumeration DateAugust 23, 2010

Last NPPES UpdateAugust 30, 20224 updates tracked since enumeration

NPPES CertifiedAugust 30, 2022

✔ NPI 1255647673 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in CA · C169256

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License C169256 (CA)

275 THE CROSSROADS BLVD STE A, Carmel, CA 93923

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Other Identifiers 1

Other52164CT · License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.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

Dr. Jaya Prakash Sugunaraj 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 ID6608019567

PECOS Enrollment IDI20220908001013

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.

Medicare Billing Reassignments

Medicare enrollment records show Jaya Prakash Sugunaraj reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Montage Medical Group

0.1 mi

Internal Medicine

275 THE CROSSROADS BLVD STE A
Carmel, CA 93923

Reassigned Medicare billing, California enrollment
155 clinicians in this Medicare group

NPI 1770710709 (831) 658-3639

Community Hospital Of The Monterey Peninsula

2.8 mi

General Acute Care Hospital

23625 HOLMAN HWY
Monterey, CA 93940

Reassigned Medicare billing, California enrollment
245 clinicians in this Medicare group

NPI 1225285810 (831) 624-5311

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 10

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.

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

324 services140 patients

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.

216 services137 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.

101 services75 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

61 services61 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

50 services50 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

49 services49 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 93923 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

$139.84 typical visit price

range $61.69 – $184.30

Typical copayment $34.96 (range $15.42 – $46.07)

Most-billed visit code 99204

Established Patient

$108.04 typical visit price

range $20.34 – $151.02

Typical copayment $27.01 (range $5.08 – $37.75)

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.

Referred Medical Equipment & Supplies CMS DME claims 4

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers13 claims13 services$20.28 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

3 suppliers22 claims22 services$95.28 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

2 suppliers11 claims780 services$0.74 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

4 suppliers11 claims11 services$21.38 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.

JOHN M OBERT-HONG MD

Family Medicine