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DR. DANIEL ANDREW SUSSMAN MD
NPI 1316148869
Internal Medicine - Gastroenterology in Miami, FL

Active since May 31, 2007PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
1475 NW 12TH AVE, SUITE 1177, MIAMI, FL 33136(305) 243-8644(305) 243-3762 Get Directions Write a Review

NPPES record last updated: January 31, 2013. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Dr. Daniel Andrew Sussman Md NPPES

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

DR. DANIEL ANDREW SUSSMAN MD (NPI 1316148869) is an individual gastroenterology provider in Miami, Florida, licensed in Florida (ME0101269) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Jackson Health System, and is a graduate of University Of Miami, Lm Miller School Of Medicine (2002).

NPPES Registry Identity

NPI1316148869
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. DANIEL ANDREW SUSSMANCredential: MD
Location Address1475 NW 12TH AVE, SUITE 1177Miami, FL 33136-1002
Mailing Address1500 Nw 12th Ave, Jmt East-1007Miami, FL 33136-1051 · (305) 243-4664 · Fax (305) 243-9927
Phone(305) 243-8644
Fax(305) 243-3762
Sole ProprietorNo
Medical School CMSUniversity Of Miami, Lm Miller School Of MedicineGraduated 2002
Enumeration DateMay 31, 2007
Last NPPES UpdateJanuary 31, 2013
✔ NPI 1316148869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in FL · ME0101269
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
1475 NW 12TH AVE, Miami, FL 33136
Open in Google Maps ↗

Other Identifiers 2

Medicare PINAK779FL
Medicaid281172300FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, AmeriHealth Caritas Next and more.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. Daniel Andrew Sussman 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 ID6709959828
PECOS Enrollment IDI20080723000475
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 Reassignment

Medicare enrollment records show Daniel Sussman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of Miami
Same address
Radiation Oncology
1475 NW 12TH AVE, BOX 016960 M851
Miami, FL 33136
  • Reassigned Medicare billing, Florida enrollment
  • 3,639 clinicians in this Medicare group
NPI 1689624108 (305) 243-7688

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 11

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 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.
68 services60 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.
46 services42 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 services30 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.
27 services24 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.
26 services26 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

Hospital Affiliations CMS Care Compare

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

Jackson Health System

Acute Care Hospitals · Miami, FL
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100022
Location1611 NW 12th AveMiami, FL 33136 · Miami-Dade County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33136 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
$141.56 typical visit price
range $60.92 – $187.05
Typical copayment $35.39 (range $15.23 – $46.76)
Most-billed visit code 99204
Established Patient
$107.17 typical visit price
range $18.99 – $150.24
Typical copayment $26.79 (range $4.74 – $37.56)
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality92.61
Promoting Interoperability100
Improvement Activities40

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.
4%48 patients
Breast Cancer Screening
46%224 patients2/55-star benchmark: 93%
Cervical Cancer Screening
25%287 patients2/55-star benchmark: 98%
Colorectal Cancer Screening
68%384 patients4/55-star benchmark: 88%
Controlling High Blood Pressure
72%125 patients4/55-star benchmark: 91%
Diabetes: Eye Exam
41%81 patients2/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
42%81 patients3/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
96%881 patients4/55-star benchmark: 100%
e-Prescribing
98%250 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
98%203 patients4/55-star benchmark: 100%
HIV Screening
28%565 patients2/55-star benchmark: 60%
Oncology: Medical and Radiation - Pain Intensity Quantified
100%35 patients5/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
51%608 patients3/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
94%577 patients4/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
32%599 patients3/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 100% · 103 patients
98%103 patients
Provide Patients Electronic Access to Their Health Information
100%209 patients5/55-star benchmark: 100%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 14% · 218 patients
Patients totalRate: 21% · 218 patients
19%218 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.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034
Other-Enteral and Parenteral · category OB006N
1 supplier11 claims336 services$2.48 avg. paid by Medicare
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4150
Other-Enteral and Parenteral · category OB006N
1 supplier11 claims5,544 services$0.33 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 20

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

MS. ALISSETTE NAVEDA ARNP
Nurse Practitioner (Family)
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-5360
WALTER G BRADLEY
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
1475 NW 12TH AVE, BOX 016960 M851
MIAMI, FL 33136
Miami-Dade County (305) 243-7520
DR. EVAN H SCHLAM MD
Dermatology
1475 NW 12TH AVE, BOX 016960
MIAMI, FL 33136
Miami-Dade County (305) 243-7688
DR. NESTOR RICARDO VILLAMIZAR M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-2363
MS. LINDSAY MARIE THORNTON MD
Radiology (Vascular & Interventional Radiology)
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-5512
DR. GLENDA C HARRIS PH.D., L.AC.
Acupuncturist
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-1470
IVAYLO MIHAYLOV
Radiology (Radiation Oncology)
1475 NW 12TH AVE, SUITE 1500
MIAMI, FL 33136
Miami-Dade County (305) 243-8223
LOURDES MESTRE VALDES APRN
Nurse Practitioner (Gerontology)
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-4902

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 Daniel Sussman's NPI number?

The NPI number for Daniel Sussman is 1316148869. It was assigned to this individual provider in the NPPES registry on May 31, 2007.

Where is Daniel Sussman located?

Daniel Sussman practices at 1475 NW 12th Ave Suite 1177, Miami, FL 33136. The listed phone number is (305) 243-8644.

What is Daniel Sussman's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Daniel Sussman enrolled in Medicare?

Yes. Daniel Sussman 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.

Which organization bills Medicare for Daniel Sussman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Daniel Sussman reassigns Medicare benefits to University Of Miami (Miami, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Daniel Sussman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Daniel Sussman accept?

Health plans from Ambetter Health, Ambetter of Alabama, AmeriHealth Caritas Next, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 2 other insurers list Daniel Sussman 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 Daniel Sussman affiliated with any hospitals?

According to CMS data, Daniel Sussman is affiliated with Jackson Health System.

When was this NPI record last updated?

The NPPES record for Daniel Sussman was last updated on January 31, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.