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GERALD SUGINO M.D.
NPI 1427036284
Internal Medicine in Mission Viejo, CA

Active since January 03, 2006PECOS EnrolledAccepts Medicare Assignment
26732 CROWN VALLEY PKWY STE 170, MISSION VIEJO, CA 92691(949) 365-2444(949) 365-2356 Get Directions Write a Review

NPPES record last updated: November 10, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 10, 2021, Oct 28, 2020, Jul 2, 2019 (3 updates tracked since 2019).

About Gerald Sugino M.d. NPPES

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

GERALD SUGINO M.D. (NPI 1427036284) is an individual internal medicine provider in Mission Viejo, California, licensed in California (G50977) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Mission Viejo, and is a graduate of University Of California, San Diego School Of Medicine (1982).

NPPES Registry Identity

NPI1427036284
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameGERALD SUGINOCredential: M.D.
Location Address26732 CROWN VALLEY PKWY STE 170Mission Viejo, CA 92691-6337
Mailing Address26732 Crown Valley Pkwy Ste 170Mission Viejo, CA 92691-6337 · (949) 365-2444 · Fax (949) 365-2356
Phone(949) 365-2444
Fax(949) 365-2356
Sole ProprietorNo
Medical School CMSUniversity Of California, San Diego School Of MedicineGraduated 1982
Enumeration DateJanuary 3, 2006
Last NPPES UpdateNovember 10, 20213 updates tracked since enumeration
NPPES CertifiedNovember 10, 2021
✔ NPI 1427036284 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · G50977
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.
26732 CROWN VALLEY PKWY STE 170, Mission Viejo, CA 92691
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Secondary Practice Location 1

Location 126800 Crown Valley Pkwy, SUITE 315Mission Viejo, CA 92691-6384 · Phone (949) 364-6000 · Fax (949) 364-1204

Other Identifiers 1

Medicaid00G509770CA

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

Gerald Sugino 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 ID5597799114
PECOS Enrollment IDI20050922001247
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 Gerald Sugino reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Providence Medical Foundation
0.1 mi
Family Medicine
26522 LA ALAMEDA, SUITE 120
Mission Viejo, CA 92691
  • Reassigned Medicare billing, California enrollment
  • 1,699 clinicians in this Medicare group
NPI 1427305960 (949) 364-9631

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 7

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 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.
464 services160 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
125 services120 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.
111 services77 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.
74 services72 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.
36 services35 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.
13 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92691 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
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
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

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
3 suppliers16 claims16 services$62.91 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 2

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

ADELINE MARCELO BARNEY NP
Nurse Practitioner (Family)
26732 CROWN VALLEY PKWY STE 170
MISSION VIEJO, CA 92691
Orange County (949) 364-7246
ERIK FINLAYSON M.D.
Internal Medicine
26732 CROWN VALLEY PKWY STE 170
MISSION VIEJO, CA 92691
Orange County (949) 365-2444

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 Gerald Sugino's NPI number?

The NPI number for Gerald Sugino is 1427036284. It was assigned to this individual provider in the NPPES registry on January 3, 2006.

Where is Gerald Sugino located?

Gerald Sugino practices at 26732 Crown Valley Pkwy Ste 170, Mission Viejo, CA 92691. The listed phone number is (949) 365-2444.

What is Gerald Sugino's specialty?

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

Is Gerald Sugino enrolled in Medicare?

Yes. Gerald Sugino 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 Gerald Sugino's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gerald Sugino reassigns Medicare benefits to Providence Medical Foundation (Mission Viejo, CA). 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 Gerald Sugino's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Gerald Sugino was last updated on November 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.