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BRANDON J SUMNER D.O.
NPI 1295098499
Surgery in Denison, TX

Active since June 21, 2012PECOS EnrolledAccepts Medicare Assignment
78.17/100
CMS Quality Rating
5012 S US HIGHWAY 75 STE 105, DENISON, TX 75020(903) 416-6490(903) 463-1201 Get Directions Write a Review

NPPES record last updated: November 18, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 18, 2019, Mar 17, 2018, Aug 3, 2017 (3 updates tracked since 2017).

About Brandon J Sumner D.o. NPPES

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

BRANDON J SUMNER D.O. (NPI 1295098499) is an individual surgery provider in Denison, Texas, licensed in Iowa (R-09531) and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS, is affiliated with Texoma Medical Center, and maintains a secondary practice location in Des Moines.

NPPES Registry Identity

NPI1295098499
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameBRANDON J SUMNERCredential: D.O.
Location Address5012 S US HIGHWAY 75 STE 105Denison, TX 75020-4611
Mailing Address5012 S Us Highway 75 Ste 300, Att. BillingDenison, TX 75020-4589 · (903) 416-6490 · Fax (903) 463-1201
Phone(903) 416-6490
Fax(903) 463-1201
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateJune 21, 2012
Last NPPES UpdateNovember 18, 20193 updates tracked since enumeration
✔ NPI 1295098499 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in IA · R-09531
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.
5012 S US HIGHWAY 75 STE 105, Denison, TX 75020
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Secondary Practice Location 1

Location 11111 6th AveDes Moines, IA 50314-2613 · Phone (515) 643-2261 · Fax (515) 643-5802

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, UnitedHealthcare.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

Brandon J Sumner D.o. 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 ID6406007749
PECOS Enrollment IDI20170801001096
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 6

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.

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.
72 services68 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.
57 services57 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
29 services16 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
26 services13 patients
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.
25 services21 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.
11 services11 patients

Hospital Affiliations CMS Care Compare

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

Texoma Medical Center

Acute Care Hospitals · Denison, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450324
Location5016 S Us Highway 75Denison, TX 75020 · Grayson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75020 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
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.

78.17/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality67.98
Promoting Interoperability100
Improvement Activities40
Cost54.58

Other Providers at the Same Location NPPES 4

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

MR. GEORGE TOMPKINS III PA-C
Physician Assistant
5012 S US HIGHWAY 75 STE 105
DENISON, TX 75020
Grayson County (903) 416-6490
MATTHEW BURRUSS M.D.
Surgery
5012 S US HIGHWAY 75 STE 105
DENISON, TX 75020
Grayson County (903) 416-6490
ROLANDO P ORO M.D.
Surgery
5012 S US HIGHWAY 75 STE 105
DENISON, TX 75020
Grayson County (903) 416-6490
MORGAN FLOYD
Surgery
5012 S US HIGHWAY 75 STE 105
DENISON, TX 75020
Grayson County (903) 416-6490

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 Brandon Sumner's NPI number?

The NPI number for Brandon Sumner is 1295098499. It was assigned to this individual provider in the NPPES registry on June 21, 2012.

Where is Brandon Sumner located?

Brandon Sumner practices at 5012 S Us Highway 75 Ste 105, Denison, TX 75020. The listed phone number is (903) 416-6490.

What is Brandon Sumner's specialty?

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

Is Brandon Sumner enrolled in Medicare?

Yes. Brandon 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 Brandon Sumner accept?

Health plans from Blue Cross and Blue Shield of Texas and UnitedHealthcare list Brandon 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 Brandon Sumner affiliated with any hospitals?

According to CMS data, Brandon Sumner is affiliated with Texoma Medical Center.

When was this NPI record last updated?

The NPPES record for Brandon Sumner was last updated on November 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.