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DR. JEFFREY M SUMNER M.D.
NPI 1457330318
Orthopaedic Surgery in Hamden, CT

Active since January 10, 2006PECOS EnrolledAccepts Medicare Assignment
82.17/100
CMS Quality Rating
2416 WHITNEY AVE STE 3, HAMDEN, CT 06518(203) 752-3169(203) 654-2509 Get Directions Write a Review

NPPES record last updated: May 18, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 18, 2026, Jul 24, 2021, Dec 6, 2017 and 1 more (4 updates tracked since 2016).

About Dr. Jeffrey M Sumner M.d. NPPES

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

DR. JEFFREY M SUMNER M.D. (NPI 1457330318) is an individual orthopaedic surgery provider in Hamden, Connecticut, licensed in Connecticut (26075) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Albany Medical College Of Union University (1979).

NPPES Registry Identity

NPI1457330318
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. JEFFREY M SUMNERCredential: M.D.
Location Address2416 WHITNEY AVE STE 3Hamden, CT 06518-3249
Mailing Address2 Barnes Industrial Rd SWallingford, CT 06492-2486 · (203) 626-0160 · Fax (203) 294-6734
Phone(203) 752-3169
Fax(203) 654-2509
Sole ProprietorNo
Medical School CMSAlbany Medical College Of Union UniversityGraduated 1979
Enumeration DateJanuary 10, 2006
Last NPPES UpdateMay 18, 20264 updates tracked since enumeration
NPPES CertifiedMay 18, 2026
✔ NPI 1457330318 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in CT · 26075
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Also ListedOrthopaedic Surgery · Orthopaedic Surgery of the SpineTaxonomy 207XS0117X · License 26075 (CT)
2416 WHITNEY AVE STE 3, Hamden, CT 06518
Open in Google Maps ↗

Secondary Practice Locations 2

Location 184 N Main StBranford, CT 06405-3061 · Phone (203) 483-2509 · Fax (203) 483-2513
Location 2235 Boston Post RdOrange, CT 06477-3229 · Phone (203) 795-4784 · Fax (203) 799-1179

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

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

Dr. Jeffrey M Sumner 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 ID5395753396
PECOS Enrollment IDI20060404000291
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 Jeffrey Sumner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mill Hill Medical Consultants Inc
5.9 mi
Hospitalist
20 YORK ST, CB 2041
New Haven, CT 06510
  • Reassigned Medicare billing, Connecticut enrollment
  • Medicare enrollment name: Northeast Medical Group Inc
  • 1,824 clinicians in this Medicare group
NPI 1952624769 (203) 688-4741

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 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.
482 services167 patients
X-ray of lower and sacral spine, 2-3 views 72100
An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.
133 services84 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
62 services30 patients
X-ray of upper spine, 2-3 views 72040
An X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.
37 services24 patients
X-ray of pelvis, 1-2 views 72170
An X-ray of the pelvis, 1-2 views, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the lower part of your torso. These images help to detect any abnormalities or injuries in your hip bones and surrounding structures.
20 services12 patients
Mri scan of lower spinal canal without contrast 72148
An MRI scan of the lower spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to produce detailed images of your lower spine. This helps identify issues like disc problems, tumors, or nerve conditions. No dye is used.
19 services19 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06518 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$75.55 typical visit price
range $19.76 – $149.26
Typical copayment $18.88 (range $4.94 – $37.31)
Most-billed visit code 99213
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.

82.17/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality85.2
Improvement Activities40
Cost67.71

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.

CONNECTICUT ORTHOPAEDIC SPECIALISTS, PC
Orthopaedic Surgery
2416 WHITNEY AVE STE 3
HAMDEN, CT 06518
South Central Connecticut Planning Region (203) 752-3100
MS. SHERRI A ROBTOY PA-C
Physician Assistant (Medical)
2416 WHITNEY AVE STE 3
HAMDEN, CT 06518
South Central Connecticut Planning Region (203) 407-3574
DR. ERIC MICHAEL PADEGIMAS M.D.
Orthopaedic Surgery
2416 WHITNEY AVE STE 3
HAMDEN, CT 06518
South Central Connecticut Planning Region (203) 407-3504

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 Jeffrey Sumner's NPI number?

The NPI number for Jeffrey Sumner is 1457330318. It was assigned to this individual provider in the NPPES registry on January 10, 2006.

Where is Jeffrey Sumner located?

Jeffrey Sumner practices at 2416 Whitney Ave Ste 3, Hamden, CT 06518. The listed phone number is (203) 752-3169.

What is Jeffrey Sumner's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Jeffrey Sumner enrolled in Medicare?

Yes. Jeffrey Sumner 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 Jeffrey Sumner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeffrey Sumner reassigns Medicare benefits to Mill Hill Medical Consultants Inc (New Haven, CT). 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 Jeffrey Sumner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jeffrey Sumner accept?

Health plans from Anthem Blue Cross and Blue Shield list Jeffrey Sumner 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 Jeffrey Sumner was last updated on May 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.