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MELISSA DIANE SUGAR M.D.
NPI 1447403456
Internal Medicine in Espanola, NM

Active since November 04, 2008PECOS EnrolledAccepts Medicare Assignment
83.84/100
CMS Quality Rating
1010 SPRUCE STREET, HOSPITALIST-ESPANOLA, ESPANOLA, NM 87532(505) 753-7111(053) 670-2885 Get Directions Write a Review

NPPES record last updated: June 27, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Melissa Diane Sugar M.d. NPPES

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

MELISSA DIANE SUGAR M.D. (NPI 1447403456) is an individual internal medicine provider in Espanola, New Mexico, licensed in New Mexico (MD2012-0505) and active in the NPI registry since November 2008. She is enrolled in Medicare PECOS, is affiliated with Presbyterian Espanola Hospital, and is a graduate of Tulane University School Of Medicine (2008).

NPPES Registry Identity

NPI1447403456
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameMELISSA DIANE SUGARCredential: M.D.
Location Address1010 SPRUCE STREET, HOSPITALIST-ESPANOLAEspanola, NM 87532-2746
Mailing AddressPo Box 26666Albuquerque, NM 87125-6666
Phone(505) 753-7111
Fax(053) 670-2885
Sole ProprietorNo
Medical School CMSTulane University School Of MedicineGraduated 2008
Enumeration DateNovember 4, 2008
Last NPPES UpdateJune 27, 2024
NPPES CertifiedJune 19, 2024
✔ NPI 1447403456 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NM · MD2012-0505
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.
1010 SPRUCE STREET, Espanola, NM 87532
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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

Melissa Diane Sugar 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 ID6901077205
PECOS Enrollment IDI20120828000075
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 Reassignments

2

Medicare enrollment records show Melissa Sugar reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Presbyterian Healthcare Services
Same address
Rural
1010 SPRUCE ST
Espanola, NM 87532
  • Reassigned Medicare billing, New Mexico enrollment
  • 2,331 clinicians in this Medicare group
NPI 1154307593 (505) 753-7111
Hospitalist Medicine Physicians Of Texas, PLLC
751 mi
Internal Medicine
18951 N MEMORIAL DR
Humble, TX 77338
  • Reassigned Medicare billing, New Mexico enrollment
  • 251 clinicians in this Medicare group
NPI 1629307095 (281) 540-7700

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 5

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.
140 services76 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.
61 services57 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.
38 services37 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.
22 services22 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.
19 services15 patients

Hospital Affiliations CMS Care Compare 2

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

Presbyterian Espanola Hospital

Acute Care Hospitals · Espanola, NM
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number320011
Location1010 Spruce StreetEspanola, NM 87532 · Rio Arriba County
Emergency services Birthing friendly

Presbyterian Hospital

Acute Care Hospitals · Albuquerque, NM
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number320021
Location1100 Central Avenue SEAlbuquerque, NM 87106 · Bernalillo County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87532 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
$126.21 typical visit price
range $54.26 – $166.80
Typical copayment $31.55 (range $13.56 – $41.70)
Most-billed visit code 99204
Established Patient
$96.38 typical visit price
range $17.00 – $135.35
Typical copayment $24.09 (range $4.25 – $33.83)
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.

83.84/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality84.59
Promoting Interoperability100
Improvement Activities40
Cost58.63

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.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers15 claims15 services$18.49 avg. paid by Medicare
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 supplier11 claims11 services$108.50 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.

BIATRIS BARRERA MD
Obstetrics & Gynecology
1010 SPRUCE STREET, PRESBYTERIAN ESPANOLA HOSPITAL
ESPANOLA, NM 87532
Rio Arriba County (505) 367-0365
RONNIE JAMES FLORES CPSW
Peer Specialist
1010 SPRUCE STREET, EMERGENCY MEDICINE
ESPANOLA, NM 87532
Rio Arriba County (505) 288-0673

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 Melissa Sugar's NPI number?

The NPI number for Melissa Sugar is 1447403456. It was assigned to this individual provider in the NPPES registry on November 4, 2008.

Where is Melissa Sugar located?

Melissa Sugar practices at 1010 Spruce Street Hospitalist-Espanola, Espanola, NM 87532. The listed phone number is (505) 753-7111.

What is Melissa Sugar's specialty?

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

Is Melissa Sugar enrolled in Medicare?

Yes. Melissa Sugar 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 organizations bill Medicare for Melissa Sugar's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Melissa Sugar reassigns Medicare benefits to 2 organizations: Presbyterian Healthcare Services (Espanola, NM) and Hospitalist Medicine Physicians Of Texas, PLLC (Humble, TX). Each 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 Melissa Sugar's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Melissa Sugar affiliated with any hospitals?

According to CMS data, Melissa Sugar is affiliated with Presbyterian Espanola Hospital and Presbyterian Hospital.

When was this NPI record last updated?

The NPPES record for Melissa Sugar was last updated on June 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.