WILLIAM T CUMMINS MD
NPI 1265483184
Surgery in Abingdon, VA

Q: What is William Cummins's NPI number?

The NPI number for William Cummins is 1265483184. It was assigned to this individual provider in the NPPES registry on May 15, 2006.

Q: What is William Cummins's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for William Cummins was last updated on February 1, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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 May 15, 2006PECOS EnrolledAccepts Medicare Assignment

75.7/100

CMS Quality Rating

16000 JOHNSTON MEMORIAL DR, SUITE 101, ABINGDON, VA 24211(276) 258-1777(276) 258-1778 Get Directions Write a Review

NPPES record last updated: February 1, 2017. Verified against the NPPES registry weekly; last sync: August 23, 2026.

On this page

About William T Cummins Md NPPES

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

WILLIAM T CUMMINS MD (NPI 1265483184) is an individual surgery provider in Abingdon, Virginia, licensed in Virginia (0101241143) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Wellmont Bristol Regional Medical Center, and is a graduate of East Tennessee State University Quillen College Of Medicine (1998).

NPPES Registry Identity

NPI1265483184

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameWILLIAM T CUMMINSCredential: MD

Location Address16000 JOHNSTON MEMORIAL DR, SUITE 101Abingdon, VA 24211-7659

Mailing Address16000 Johnston Memorial Dr, Suite 101Abingdon, VA 24211-7659 · (276) 258-1777 · Fax (276) 258-1778

Phone(276) 258-1777

Fax(276) 258-1778

Sole ProprietorNo

Medical School CMSEast Tennessee State University Quillen College Of MedicineGraduated 1998

Enumeration DateMay 15, 2006

Last NPPES UpdateFebruary 1, 2017

✔ NPI 1265483184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

Licenses✔ Licensed in VA · 0101241143✔ Licensed in TN · MD37429

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

16000 JOHNSTON MEMORIAL DR, Abingdon, VA 24211

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Other Identifiers 7

Medicare PIN013494A49VA

Medicare PIN3885348TN

Medicare UPINC09949VA

Medicaid3885348TN

OtherP00408045VA · Railroad Medicare

Medicare UPINH84137

Medicaid1265483184VA

Accepted Insurance

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

William T Cummins 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 ID2365489978

PECOS Enrollment IDI20070605000493

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 17

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.

44 services40 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

39 services39 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

33 services31 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

32 services31 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.

31 services29 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.

26 services26 patients

Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery 45384

This procedure involves using a flexible tube with a camera, called an endoscope, to view the large intestine. If any abnormal growths or polyps are found, they are removed with an electrically-heated instrument. This is a common way to prevent bowel issues.

21 services21 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

21 services21 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.

20 services20 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

19 services19 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

17 services17 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

15 services15 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

15 services14 patients

Insertion of central venous tube with port (5 years or older) 36561

A central venous tube with port is a small, flexible tube inserted into a large vein, usually in the chest. It allows for easy administration of medication, fluids, or blood products over a long period. A port is attached under the skin for easy access. It's safe for individuals aged 5 and above.

14 services14 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

13 services13 patients

Removal of gallbladder using an endoscope 47562

This procedure, known as endoscopic gallbladder removal, involves a surgeon using a special tool called an endoscope to remove your gallbladder through small incisions. It's typically done to treat gallstones and related complications. It's a less invasive method, often leading to quicker recovery.

12 services12 patients

Fluoroscopic guidance for insertion or removal of central vein access device 77001

Fluoroscopic guidance for central vein access device insertion or removal is a procedure where a special X-ray, called a fluoroscope, is used to help accurately place or remove a device in a central vein. This device aids in delivering medications or collecting blood samples.

12 services12 patients

Hospital Affiliations CMS Care Compare 4

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

Wellmont Bristol Regional Medical Center

Acute Care Hospitals · Bristol, TN

1/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number440012

LocationOne Medical Park BlvdBristol, TN 37620 · Sullivan County

Emergency services Birthing friendly

Russell County Hospital

Acute Care Hospitals · Lebanon, VA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490002

Location58 Carroll StreetLebanon, VA 24266 · Russell County

Emergency services

Smyth County Community Hospital

Acute Care Hospitals · Marion, VA

OwnershipVoluntary non-profit - Private

CMS Certification Number490038

Location245 Medical Park DriveMarion, VA 24354 · Smyth County

Emergency services

Johnston Memorial Hospital

Acute Care Hospitals · Abingdon, VA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490053

Location16000 Johnston Memorial DriveAbingdon, VA 24211 · Washington County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 24211 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

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$70.08 typical visit price

range $18.07 – $138.91

Typical copayment $17.52 (range $4.51 – $34.72)

Most-billed visit code 99213

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.

75.7/100

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

Individually scored

Quality

66.82

Promoting Interoperability

Improvement Activities

Cost

54.68

Reported Quality Measures

Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture

Lower rates are better for this measure.

0%59 patients

Breast Cancer Screening

70%166 patients4/55-star benchmark: 93%

Cervical Cancer Screening

28%130 patients2/55-star benchmark: 98%

Closing the Referral Loop: Receipt of Specialist Report

10%165 patients1/55-star benchmark: 87%

Colorectal Cancer Screening

56%359 patients3/55-star benchmark: 88%

Controlling High Blood Pressure

57%288 patients3/55-star benchmark: 91%

Diabetes: Eye Exam

0%105 patients1/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

50%105 patients3/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

97%1,002 patients4/55-star benchmark: 100%

e-Prescribing

98%179 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

77%265 patients4/55-star benchmark: 100%

HIV Screening

9%406 patients1/55-star benchmark: 60%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

36%612 patients2/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

40%447 patients2/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

20%394 patients2/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 83% · 444 patients

Patients screened: 99% · 444 patients

42%125 patients2/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

100%262 patients5/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

74%263 patients3/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 8% · 247 patients

Patients totalRate: 16% · 247 patients

16%247 patients3/55-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.

Other Providers at the Same Location NPPES 20

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

ANGELA MARIE COOPER

Pharmacist

16000 JOHNSTON MEMORIAL DR
ABINGDON, VA 24211

Washington County (276) 258-3050

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Dermatology

16000 JOHNSTON MEMORIAL DR, SUITE 101B
ABINGDON, VA 24211

Washington County (276) 258-1777

DR. JOE RUPE MD

Internal Medicine

16000 JOHNSTON MEMORIAL DR
ABINGDON, VA 24211

Washington County (276) 258-4050

MISS CATHY ANN HOPKINS PA

Physician Assistant

16000 JOHNSTON MEMORIAL DR
ABINGDON, VA 24211

Washington County (276) 258-1800

DAVID HUNT SMITH MD

Surgery

16000 JOHNSTON MEMORIAL DR, SUITE 101
ABINGDON, VA 24211

Washington County (276) 258-1777

JOHNSTON MEMORIAL HOSPITAL

General Acute Care Hospital

16000 JOHNSTON MEMORIAL DR
ABINGDON, VA 24211

Washington County (276) 258-1100

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Urology

16000 JOHNSTON MEMORIAL DR, SUITE 312D
ABINGDON, VA 24211

Washington County (276) 783-5400

DR. BEVERLY TARA SMITH DO

Internal Medicine

16000 JOHNSTON MEMORIAL DR
ABINGDON, VA 24211

Washington County (276) 258-1000

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 William Cummins's NPI number?

The NPI number for William Cummins is 1265483184. It was assigned to this individual provider in the NPPES registry on May 15, 2006.

Where is William Cummins located?

William Cummins practices at 16000 Johnston Memorial Dr Suite 101, Abingdon, VA 24211. The listed phone number is (276) 258-1777.

What is William Cummins's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is William Cummins enrolled in Medicare?

Yes. William Cummins 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 William Cummins accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of North Carolina and 2 other insurers list William Cummins 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 William Cummins affiliated with any hospitals?

According to CMS data, William Cummins is affiliated with Wellmont Bristol Regional Medical Center, Russell County Hospital, Smyth County Community Hospital and Johnston Memorial Hospital.

When was this NPI record last updated?

The NPPES record for William Cummins was last updated on February 1, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.