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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SOWMIKA RAO MD
NPI 1356862254
Internal Medicine - Rheumatology in Cumming, GA

Active since June 29, 2017PECOS EnrolledAccepts Medicare Assignment
102 MARY ALICE PARK RD STE 805, CUMMING, GA 30040(770) 284-3150(770) 284-3170 Get Directions Write a Review

NPPES record last updated: June 27, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 7, 2021, Jul 30, 2020, Jun 29, 2017 (3 updates tracked since 2017).

About Sowmika Rao Md NPPES

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

SOWMIKA RAO MD (NPI 1356862254) is an individual rheumatology provider in Cumming, Georgia, licensed in Georgia (111780) and active in the NPI registry since June 2017. She is enrolled in Medicare PECOS, maintains a secondary practice location in Canton, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1356862254
Entity TypeIndividualFemale
Primary Taxonomy207RR0500X
Provider Legal NameSOWMIKA RAOCredential: MD
Location Address102 MARY ALICE PARK RD STE 805Cumming, GA 30040-4702
Mailing Address11731 Pointe PlRoswell, GA 30076-4636 · (770) 284-3150
Phone(770) 284-3150
Fax(770) 284-3170
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateJune 29, 2017
Last NPPES UpdateJune 27, 20263 updates tracked since enumeration
NPPES CertifiedJune 27, 2026
✔ NPI 1356862254 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
License✔ Licensed in GA · 111780
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
102 MARY ALICE PARK RD STE 805, Cumming, GA 30040
Open in Google Maps ↗

Secondary Practice Location 1

Location 1120 Oakside Ct Ste CCanton, GA 30114-2478 · Phone (770) 284-3150 · Fax (770) 284-3170

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include McLaren Health Plan Community, Priority Health.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

Sowmika Rao 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 ID143646810
PECOS Enrollment IDI20260527003227
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 3

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.
23 services23 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.
16 services15 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
12 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30040 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

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.

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
1 supplier19 claims19 services$90.65 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier21 claims21 services$33.09 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 3

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

KAITLIN NEESE MCDANIEL PA-C
Internal Medicine (Rheumatology)
102 MARY ALICE PARK RD STE 805
CUMMING, GA 30040
Forsyth County (678) 438-5921
DR. OMAR T KHAN DO
Internal Medicine (Rheumatology)
102 MARY ALICE PARK RD STE 805
CUMMING, GA 30040
Forsyth County (770) 284-3150
DR. DEEPTHI RAO M.D.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
102 MARY ALICE PARK RD STE 805
CUMMING, GA 30040
Forsyth County (770) 284-3150

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 Sowmika Rao's NPI number?

The NPI number for Sowmika Rao is 1356862254. It was assigned to this individual provider in the NPPES registry on June 29, 2017.

Where is Sowmika Rao located?

Sowmika Rao practices at 102 Mary Alice Park Rd Ste 805, Cumming, GA 30040. The listed phone number is (770) 284-3150.

What is Sowmika Rao's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Sowmika Rao enrolled in Medicare?

Yes. Sowmika Rao 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 Sowmika Rao accept?

Health plans from McLaren Health Plan Community and Priority Health list Sowmika Rao 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.

When was this NPI record last updated?

The NPPES record for Sowmika Rao was last updated on June 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 42 days 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.