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DR. SUMUL N. RAVAL M.D.
NPI 1376526673
Psychiatry & Neurology - Neurology in West Long Branch, NJ

Active since November 21, 2005PECOS EnrolledAccepts Medicare Assignment
32.81/100
CMS Quality Rating
100 HWY 36, SUITE 1A, WEST LONG BRANCH, NJ 07764(732) 229-6200(732) 229-6201 Get Directions Write a Review

NPPES record last updated: April 12, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Sumul N. Raval M.d. NPPES

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

DR. SUMUL N. RAVAL M.D. (NPI 1376526673) is an individual neurology provider in West Long Branch, New Jersey, licensed in New Jersey (25MA07183700) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Riverview Medical Center, and is a graduate of Other (1990).

NPPES Registry Identity

NPI1376526673
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameDR. SUMUL N. RAVALCredential: M.D.
Location Address100 HWY 36, SUITE 1AWest Long Branch, NJ 07764-1462
Mailing Address100 Hwy 36, Suite 1aWest Long Branch, NJ 07764-1462 · (732) 229-6200 · Fax (732) 229-6201
Phone(732) 229-6200
Fax(732) 229-6201
Sole ProprietorYes
Medical School CMSOtherGraduated 1990
Enumeration DateNovember 21, 2005
Last NPPES UpdateApril 12, 2013
✔ NPI 1376526673 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License✔ Licensed in NJ · 25MA07183700
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
100 HWY 36, West Long Branch, NJ 07764
Open in Google Maps ↗

Other Identifiers 3

Medicare UPINH74667NJ
Medicaid0006394NJ
Medicare ID-Type Unspecified070987NJ

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. Sumul N. Raval 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 ID3274520333
PECOS Enrollment IDI20040429000693
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 14

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.

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.
4,878 services973 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.
792 services434 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
708 services538 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.
652 services626 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.
342 services335 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
173 services113 patients

Hospital Affiliations CMS Care Compare 5

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

Riverview Medical Center

Acute Care Hospitals · Red Bank, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310034
LocationOne Riverview PlazaRed Bank, NJ 07701 · Monmouth County
Emergency services Birthing friendly

Community Medical Center

Acute Care Hospitals · Toms River, NJ
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310041
Location99 Rt 37 WestToms River, NJ 08755 · Ocean County
Emergency services Birthing friendly

Jersey Shore University Medical Center

Acute Care Hospitals · Neptune, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310073
Location1945 State Route 33Neptune, NJ 07753 · Monmouth County
Emergency services Birthing friendly

Monmouth Medical Center

Acute Care Hospitals · Long Branch, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310075
Location300 Second AvenueLong Branch, NJ 07740 · Monmouth County
Emergency services Birthing friendly

Jfk Medical Center

Acute Care Hospitals · Edison, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310108
Location65 James StreetEdison, NJ 08820 · Middlesex County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07764 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
$140.34 typical visit price
range $61.59 – $185.05
Typical copayment $35.08 (range $15.39 – $46.26)
Most-billed visit code 99204
Established Patient
$107.94 typical visit price
range $20.08 – $150.98
Typical copayment $26.98 (range $5.02 – $37.74)
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.

32.81/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality40
Improvement Activities0
Cost39.39

Reported Quality Measures

Depression Utilization of the PHQ-9 Tool
The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit
Patients 4MonthsOfEnd: 28% · 46 patients
6%52 patients
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
99%3,188 patients4/55-star benchmark: 100%
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.
82%548 patients2/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
97%728 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
100%23 patients5/55-star benchmark: 88%
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.
30%568 patients2/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
73%1,376 patients4/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 99% · 918 patients
Patients tobacco: 87% · 918 patients
34%169 patients2/55-star benchmark: 98%
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…
43%568 patients2/55-star benchmark: 100%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 727 patients
4%727 patients4/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
2%568 patients
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

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

Temozolomide, oral, 5 mg J8700
Treatment-Treatment - Miscellaneous · category RX000N
4 suppliers13 claims3,162 services$0.36 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 4

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

PATRICK LEE MD
Internal Medicine (Hematology)
100 HWY 36
WEST LONG BRANCH, NJ 07764
Monmouth County (732) 222-1711
PUNIT RAJNIKANT JARIWALA M.D.
Internal Medicine
100 HWY 36, SUITE 2K
WEST LONG BRANCH, NJ 07764
Monmouth County (732) 531-6600
MARGO PETERS R.N.
Registered Nurse (Administrator)
100 HWY 36, SUITE 2C
WEST LONG BRANCH, NJ 07764
Monmouth County (732) 571-0025
SUNNY ARORA MD
Internal Medicine (Medical Oncology)
100 HWY 36
WEST LONG BRANCH, NJ 07764
Monmouth County (732) 222-1711

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 Sumul Raval's NPI number?

The NPI number for Sumul Raval is 1376526673. It was assigned to this individual provider in the NPPES registry on November 21, 2005.

Where is Sumul Raval located?

Sumul Raval practices at 100 Hwy 36 Suite 1A, West Long Branch, NJ 07764. The listed phone number is (732) 229-6200.

What is Sumul Raval's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Sumul Raval enrolled in Medicare?

Yes. Sumul Raval 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.

Is Sumul Raval affiliated with any hospitals?

According to CMS data, Sumul Raval is affiliated with Riverview Medical Center, Community Medical Center, Jersey Shore University Medical Center, Monmouth Medical Center and Jfk Medical Center.

When was this NPI record last updated?

The NPPES record for Sumul Raval was last updated on April 12, 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.