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TODD SUMLER FNP
NPI 1457600298
Nurse Practitioner - Family in Valdosta, GA

Active since September 07, 2012PECOS EnrolledAccepts Medicare Assignment
415 WOODROW WILSON DRIVE, VALDOSTA, GA 31602(229) 253-0780(229) 253-0785 Get Directions Write a Review

NPPES record last updated: September 7, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Todd Sumler Fnp NPPES

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

TODD SUMLER FNP (NPI 1457600298) is an individual family provider in Valdosta, Georgia, licensed in Georgia (RN127085) and active in the NPI registry since September 2012. He is enrolled in Medicare PECOS, is affiliated with Crisp Regional Hospital, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1457600298
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameTODD SUMLERCredential: FNP
Location Address415 WOODROW WILSON DRIVEValdosta, GA 31602
Mailing Address875 Bealuh Church RdSparks, GA 31647 · (229) 546-5209
Phone(229) 253-0780
Fax(229) 253-0785
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateSeptember 7, 2012
✔ NPI 1457600298 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in GA · RN127085
415 WOODROW WILSON DRIVE, Valdosta, GA 31602
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.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

Todd Sumler Fnp 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 ID1456502764
PECOS Enrollment IDI20121114000631
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

4

Medicare enrollment records show Todd Sumler reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Parrott Medical Clinic PC
1.8 mi
Family Medicine
804 NORTHWOOD PARK DR
Valdosta, GA 31602
  • Reassigned Medicare billing, Georgia enrollment
  • 7 clinicians in this Medicare group
NPI 1912138116 (229) 249-7888
Tift Regional Health System, Inc.
19 mi
Rural Health
172 MJ TAYLOR RD
Adel, GA 31620
  • Reassigned Medicare billing, Georgia enrollment
  • 380 clinicians in this Medicare group
NPI 1871816918 (229) 896-8500
Ear, Nose And Throat Clinic Of Coffee Co.
51 mi
Specialist
312 WESTSIDE DRIVE
Douglas, GA 31533
  • Reassigned Medicare billing, Georgia enrollment
  • 13 clinicians in this Medicare group
NPI 1891750774 (912) 384-2200
Crisp Regional Hospital Inc
82 mi
General Acute Care Hospital
902 7TH ST NORTH
Cordele, GA 31010
  • Reassigned Medicare billing, Georgia enrollment
  • 124 clinicians in this Medicare group
NPI 1700851649 (229) 271-9686

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.

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.
327 services206 patients
Test to assess middle ear function 92567
A test to assess middle ear function, also known as an impedance audiometry, helps evaluate how well your middle ear works. It measures the movement of your eardrum in response to changes in air pressure. This can help identify issues like fluid build-up, ear infections, or eardrum perforations.
123 services94 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
83 services62 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
72 services72 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
35 services34 patients
Exam of ear using a microscope 92504
An exam of the ear using a microscope allows a detailed view of the ear structures. This non-invasive procedure helps identify issues such as infections, blockages, or ear damage. It's a safe, quick, and painless way to evaluate ear health.
14 services13 patients

Hospital Affiliations CMS Care Compare

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

Crisp Regional Hospital

Acute Care Hospitals · Cordele, GA
3/5 CMS rating
OwnershipProprietary
CMS Certification Number110104
Location902 7th Street NorthCordele, GA 31015 · Crisp County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31602 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

Reported Quality Measures

Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy - Avoidance of Inappropriate Use
Percentage of patients aged 2 years and older with a diagnosis of AOE who were not prescribed systemic antimicrobial therapy
83%40 patients
Acute Otitis Externa (AOE): Topical Therapy
Percentage of patients aged 2 years and older with a diagnosis of AOE who were prescribed topical preparations
96%49 patients4/55-star benchmark: 100%
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.
100%1,060 patients5/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
92%59 patients4/55-star benchmark: 100%
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.
16%220 patients1/55-star benchmark: 100%
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…
52%633 patients3/55-star benchmark: 100%
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
14%58 patients1/55-star benchmark: 100%
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…
86%228 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
1%228 patients1/55-star benchmark: 79%
Sleep Apnea: Assessment of Sleep Symptoms
Percentage of visits for patients aged 18 years and older with a diagnosis of obstructive sleep apnea that includes documentation of an assessment of sleep symptoms, including presence or absence of snoring and daytime sleepiness
100%107 patients5/55-star benchmark: 100%
Sleep Apnea: Severity Assessment at Initial Diagnosis
Percentage of patients aged 18 years and older with a diagnosis of obstructive sleep apnea who had an apnea hypopnea index (AHI) or a respiratory disturbance index (RDI) measured at the time of initial diagnosis
100%107 patients5/55-star benchmark: 100%
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.

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 Todd Sumler's NPI number?

The NPI number for Todd Sumler is 1457600298. It was assigned to this individual provider in the NPPES registry on September 7, 2012.

Where is Todd Sumler located?

Todd Sumler practices at 415 Woodrow Wilson Drive, Valdosta, GA 31602. The listed phone number is (229) 253-0780.

What is Todd Sumler's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Todd Sumler enrolled in Medicare?

Yes. Todd Sumler 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 Todd Sumler's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Todd Sumler reassigns Medicare benefits to 4 organizations: Parrott Medical Clinic PC (Valdosta, GA), Tift Regional Health System, Inc. (Adel, GA), Ear, Nose And Throat Clinic Of Coffee Co. (Douglas, GA) and Crisp Regional Hospital Inc (Cordele, GA). 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 Todd Sumler's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Todd Sumler accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Todd Sumler 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.

Is Todd Sumler affiliated with any hospitals?

According to CMS data, Todd Sumler is affiliated with Crisp Regional Hospital.

When was this NPI record last updated?

The NPPES record for Todd Sumler was last updated on September 7, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.