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DR. GHOUSIA SULTANA M.D.
NPI 1346294279
Internal Medicine in Silver Spring, MD

Active since May 22, 2006PECOS EnrolledAccepts Medicare Assignment
12107 HERITAGE PARK CIR, SILVER SPRING, MD 20906(301) 949-7000(301) 949-7029 Get Directions Write a Review

NPPES record last updated: September 23, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Ghousia Sultana M.d. NPPES

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

DR. GHOUSIA SULTANA M.D. (NPI 1346294279) is an individual internal medicine provider in Silver Spring, Maryland, licensed in Maryland (D56691) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1987).

NPPES Registry Identity

NPI1346294279
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. GHOUSIA SULTANACredential: M.D.
Location Address12107 HERITAGE PARK CIRSilver Spring, MD 20906-4555
Mailing Address12107 Heritage Park CirSilver Spring, MD 20906-4555 · (301) 949-7000 · Fax (301) 949-7029
Phone(301) 949-7000
Fax(301) 949-7029
Sole ProprietorNo
Medical School CMSOtherGraduated 1987
Enumeration DateMay 22, 2006
Last NPPES UpdateSeptember 23, 2024
NPPES CertifiedSeptember 23, 2024
✔ NPI 1346294279 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MD · D56691
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedInternal Medicine · HematologyTaxonomy 207RH0000X · License D56691 (MD)
12107 HERITAGE PARK CIR, Silver Spring, MD 20906
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Other Identifiers 1

Medicaid699564100MD

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. Ghousia Sultana 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 ID3971572702
PECOS Enrollment IDI20040929000201
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 8

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.
206 services47 patients
Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes 99458
This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.
138 services11 patients
Insertion of needle into vein (3 years or older) 36410
This procedure involves placing a small needle into a vein, typically in the arm. It's done to collect blood for testing or to deliver medication. You may feel a quick pinch, but it's usually over in seconds. It's a common, safe procedure.
98 services45 patients
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457
This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.
90 services12 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
69 services18 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
44 services44 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20906 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
$147.85 typical visit price
range $65.18 – $194.86
Typical copayment $36.96 (range $16.29 – $48.71)
Most-billed visit code 99204
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
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.

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
99%540 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
100%193 patients5/55-star benchmark: 99%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
73%193 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
10%193 patients1/55-star benchmark: 59%
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

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

DR. GHOUSIA SULTANA, M.D, P.A.
Internal Medicine (Hematology)
12107 HERITAGE PARK CIR
SILVER SPRING, MD 20906
Montgomery County (301) 949-7000

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 Ghousia Sultana's NPI number?

The NPI number for Ghousia Sultana is 1346294279. It was assigned to this individual provider in the NPPES registry on May 22, 2006.

Where is Ghousia Sultana located?

Ghousia Sultana practices at 12107 Heritage Park Cir, Silver Spring, MD 20906. The listed phone number is (301) 949-7000.

What is Ghousia Sultana's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Ghousia Sultana enrolled in Medicare?

Yes. Ghousia Sultana 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.

When was this NPI record last updated?

The NPPES record for Ghousia Sultana was last updated on September 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.