DR. SUMIT M PATEL M.D.
NPI 1255695011
Internal Medicine - Pulmonary Disease in Chattanooga, TN

Q: What is Sumit Patel's NPI number?

The NPI number for Sumit Patel is 1255695011. It was assigned to this individual provider in the NPPES registry on June 26, 2012.

Q: What is Sumit Patel's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Sumit Patel was last updated on August 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since June 26, 2012PECOS EnrolledAccepts Medicare Assignment

94.7/100

CMS Quality Rating

725 GLENWOOD DR STE E500, CHATTANOOGA, TN 37404(423) 495-2635(423) 495-2638 Get Directions Write a Review

NPPES record last updated: August 14, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 14, 2019, Feb 8, 2017 (2 updates tracked since 2017).

On this page

About Dr. Sumit M Patel M.d. NPPES

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

DR. SUMIT M PATEL M.D. (NPI 1255695011) is an individual pulmonary disease provider in Chattanooga, Tennessee, licensed in Tennessee (59404) and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS, is affiliated with Chi Memorial Hospital- Georgia, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1255695011

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameDR. SUMIT M PATELCredential: M.D.

Location Address725 GLENWOOD DR STE E500Chattanooga, TN 37404

Mailing Address1949 Gunbarrel Rd Ste 206Chattanooga, TN 37421-7133 · (423) 495-4349 · Fax (423) 495-4934

Phone(423) 495-2635

Fax(423) 495-2638

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateJune 26, 2012

Last NPPES UpdateAugust 14, 20192 updates tracked since enumeration

✔ NPI 1255695011 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in TN · 59404

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 59404 (TN)

Also ListedHospitalistTaxonomy 208M00000X · License 59404 (TN)

725 GLENWOOD DR STE E500, Chattanooga, TN 37404

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Arkansas Health & Wellness, Ambetter from Home State 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

Dr. Sumit M Patel 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 ID8820370828

PECOS Enrollment IDI20190909003926, I20200317001380

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 24

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.

Test to measure expiratory airflow and volume 94010

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

433 services422 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.

244 services177 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

115 services73 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.

98 services96 patients

Test to measure expiratory airflow and volume 94010

91 services89 patients

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.

84 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.

73 services72 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.

71 services70 patients

Test for exercise-induced lung stress 94618

An exercise-induced lung stress test assesses how your lungs respond to physical activity. During the test, you'll exercise on a treadmill or stationary bike while your heart rate, breathing, blood pressure, and oxygen levels are monitored. This helps identify any abnormal lung responses to exercise.

67 services66 patients

Test to examine how well the lungs exchange gases 94729

66 services63 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.

54 services54 patients

Sleep study including heart rate, breathing, airflow, and effort 95806

A sleep study monitors your heart rate, breathing patterns, airflow, and physical effort while you sleep. It helps identify sleep disorders by tracking your sleep stages and cycles. This data aids doctors in diagnosing and treating sleep-related issues.

38 services38 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

36 services36 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

28 services28 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.

25 services25 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

23 services23 patients

Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811

A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.

23 services23 patients

Evaluation of use of breathing device 94664

The evaluation of a breathing device involves checking how effectively you're using it to manage your respiratory condition. It assesses the device's fit, your comfort, and your technique to ensure optimal results.

17 services17 patients

Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) G0296

This visit involves discussing the necessity of a lung cancer screening using a low dose CT scan. It's a chance to determine if you're eligible for the test and to make an informed decision about proceeding. The scan can potentially detect lung cancer early, improving treatment outcomes.

16 services15 patients

Smoking and tobacco use intensive counseling, 4-10 minutes 99406

This service provides brief, intensive counseling (4-10 minutes) to support you in quitting smoking or tobacco use. It involves discussing the risks of tobacco use, benefits of quitting, and strategies to help you stop. It's a critical step towards a healthier lifestyle.

14 services12 patients

Sleep study in sleep lab (6 years or older) 95810

A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.

13 services12 patients

Test to determine lung volumes using gas dilution or washout 94727

This test measures lung volumes by either diluting or washing out a known amount of gas in your lungs. You'll breathe in a harmless gas, then exhale. The exhaled air is analyzed to assess your lung capacity and function.

12 services12 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.

12 services12 patients

Irrigation and suction of lung airways to obtain cells using an endoscope 31624

This is a procedure where a thin, flexible tube called an endoscope is inserted through your mouth into the lungs. A small amount of saline is then introduced to wash the airways. The fluid, along with cells from the lung, is suctioned back for analysis.

11 services11 patients

Hospital Affiliations CMS Care Compare 4

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

Chi Memorial Hospital- Georgia

Acute Care Hospitals · Fort Oglethorpe, GA

OwnershipVoluntary non-profit - Private

CMS Certification Number110236

Location100 Gross Crescent CircleFort Oglethorpe, GA 30742 · Catoosa County

Emergency services

Memorial Healthcare System, Inc

Acute Care Hospitals · Chattanooga, TN

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number440091

Location2525 Desales AveChattanooga, TN 37404 · Hamilton County

Parkridge Medical Center

Acute Care Hospitals · Chattanooga, TN

4/5 CMS rating

OwnershipProprietary

CMS Certification Number440156

Location2333 Mccallie AveChattanooga, TN 37404 · Hamilton County

Emergency services

Rhea Medical Center

Critical Access Hospitals · Dayton, TN

OwnershipGovernment - Local

CMS Certification Number441310

Location9400 Rhea County HighwayDayton, TN 37321 · Rhea County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37404 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

$121.80 typical visit price

range $52.64 – $160.89

Typical copayment $30.45 (range $13.16 – $40.22)

Most-billed visit code 99204

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

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.

94.7/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

89.41

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 24

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

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

6 suppliers45 claims45 services$32.79 avg. paid by Medicare

Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003

DME-Other DME · category DE000N

2 suppliers11 claims22 services$1.12 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

5 suppliers26 claims26 services$71.85 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

4 suppliers23 claims59 services$27.19 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

6 suppliers32 claims158 services$16.31 avg. paid by Medicare

Pillow for use on nasal cannula type interface, replacement only, pair A7033

DME-Other DME · category DE001N

5 suppliers20 claims117 services$11.75 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

9 suppliers53 claims53 services$46.53 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

8 suppliers45 claims45 services$15.47 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

7 suppliers23 claims23 services$10.21 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

9 suppliers69 claims362 services$1.69 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

6 suppliers26 claims26 services$10.84 avg. paid by Medicare

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

DME-Oxygen and Supplies · category DC000N

6 suppliers76 claims76 services$15.56 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

3 suppliers15 claims15 services$909.91 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470

DME-Other DME · category DE001N

3 suppliers21 claims21 services$85.75 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

5 suppliers19 claims19 services$124.70 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

3 suppliers42 claims43 services$5.81 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

10 suppliers107 claims112 services$31.59 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

8 suppliers182 claims183 services$68.46 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

3 suppliers39 claims40 services$28.86 avg. paid by Medicare

Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605

DME-Drugs Administered Through DME · category DG006N

4 suppliers33 claims1,980 services$4.75 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

6 suppliers19 claims960 services$0.10 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

8 suppliers38 claims2,400 services$0.82 avg. paid by Medicare

Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram J7677

DME-Drugs Administered Through DME · category DG006N

1 supplier11 claims57,750 services$0.15 avg. paid by Medicare

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

DME-Other DME · category DE000N

10 suppliers59 claims59 services$25.63 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 6

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

MRS. JANICE DENISE SIMS APRN

Nurse Practitioner (Gerontology)

725 GLENWOOD DR STE E500
CHATTANOOGA, TN 37404

Hamilton County (423) 495-2635

KRISTEN MIRANDA NP

Nurse Practitioner

725 GLENWOOD DR STE E500
CHATTANOOGA, TN 37404

Hamilton County (423) 495-2635

DR. OSAMUYI IDUBOR DO

Internal Medicine (Pulmonary Disease)

725 GLENWOOD DR STE E500
CHATTANOOGA, TN 37404

Hamilton County (423) 495-2635

JOHANNA CORTES NP

Nurse Practitioner (Gerontology)

725 GLENWOOD DR STE E500
CHATTANOOGA, TN 37404

Hamilton County (423) 495-2635

DR. JESSE LAYDEN TUCKER M.D.

Internal Medicine (Pulmonary Disease)

725 GLENWOOD DR STE E500
CHATTANOOGA, TN 37404

Hamilton County (423) 495-2635

CAROLE HIGHLANDER JOHNSON FNP-C

Nurse Practitioner (Family)

725 GLENWOOD DR STE E500
CHATTANOOGA, TN 37404

Hamilton County (423) 495-2635

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 Sumit Patel's NPI number?

The NPI number for Sumit Patel is 1255695011. It was assigned to this individual provider in the NPPES registry on June 26, 2012.

Where is Sumit Patel located?

Sumit Patel practices at 725 Glenwood Dr Ste E500, Chattanooga, TN 37404. The listed phone number is (423) 495-2635.

What is Sumit Patel's specialty?

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

Is Sumit Patel enrolled in Medicare?

Yes. Sumit Patel 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 Sumit Patel accept?

Health plans from Alliant Health Plans, Inc., Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health and Ambetter of Alabama and 2 other insurers list Sumit Patel 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 Sumit Patel affiliated with any hospitals?

According to CMS data, Sumit Patel is affiliated with Chi Memorial Hospital- Georgia, Memorial Healthcare System, Inc, Parkridge Medical Center and Rhea Medical Center.

When was this NPI record last updated?

The NPPES record for Sumit Patel was last updated on August 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.