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DR. SUMI D JONES MD
NPI 1467403204
Internal Medicine in Menomonee Falls, WI

Active since May 15, 2006PECOS EnrolledAccepts Medicare Assignment
W129N7055 NORTHFIELD DR, MENOMONEE FALLS, WI 53051(262) 253-5400 Get Directions Write a Review

NPPES record last updated: January 17, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Sumi D Jones Md NPPES

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

DR. SUMI D JONES MD (NPI 1467403204) is an individual internal medicine provider in Menomonee Falls, Wisconsin, licensed in Wisconsin (46818) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Community Memorial Hospital, and is a graduate of Medical College Of Wisconsin (2001).

NPPES Registry Identity

NPI1467403204
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. SUMI D JONESCredential: MD
Location AddressW129N7055 NORTHFIELD DRMenomonee Falls, WI 53051-0538
Mailing AddressW129n7055 Northfield DrMenomonee Falls, WI 53051-0538 · (262) 253-5400
Phone(262) 253-5400
Sole ProprietorNo
Medical School CMSMedical College Of WisconsinGraduated 2001
Enumeration DateMay 15, 2006
Last NPPES UpdateJanuary 17, 2024
NPPES CertifiedJanuary 17, 2024
✔ NPI 1467403204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in WI · 46818
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.
W129N7055 NORTHFIELD DR, Menomonee Falls, WI 53051
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Other Identifiers 2

Other000017792YHumana
Medicaid1467403204WI

Accepted Insurance

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

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. Sumi D Jones Md 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 ID840269379
PECOS Enrollment IDI20040930000625
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 3

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.
93 services65 patients
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.
63 services48 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
25 services25 patients

Hospital Affiliations CMS Care Compare 2

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

Community Memorial Hospital

Acute Care Hospitals · Menomonee Falls, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520103
LocationW180 N8085 Town Hall RdMenomonee Falls, WI 53051 · Waukesha County
Emergency services

Froedtert Memorial Lutheran Hospital

Acute Care Hospitals · Milwaukee, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520177
Location9200 W Wisconsin AveMilwaukee, WI 53226 · Milwaukee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53051 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

Other Providers at the Same Location NPPES 20

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

LISA COOK PA
Physician Assistant
W129N7055 NORTHFIELD DR, BLDG A, STE 203
MENOMONEE FALLS, WI 53051
Waukesha County (262) 253-7155
FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC.
Clinic/Center (Radiology)
W129N7055 NORTHFIELD DR
MENOMONEE FALLS, WI 53051
Waukesha County (262) 251-5305
DANIEL BRUSS
Physical Therapist
W129N7055 NORTHFIELD DR
MENOMONEE FALLS, WI 53051
Waukesha County (262) 253-5400
JAMIE BONORIS
Nurse Practitioner (Family)
W129N7055 NORTHFIELD DR
MENOMONEE FALLS, WI 53051
Waukesha County (414) 805-7000
SCOTT C HICKS M.D.
Orthopaedic Surgery
W129N7055 NORTHFIELD DR, ORTHOPAEDIC SURGERY
MENOMONEE FALLS, WI 53051
Waukesha County (262) 253-5400
ALEXANDER R HENDRICKSON O.T.
Occupational Therapist
W129N7055 NORTHFIELD DR
MENOMONEE FALLS, WI 53051
Waukesha County (608) 252-2000
DR. TAMARA CARR STRUEBING PHARMD
Pharmacist
W129N7055 NORTHFIELD DR
MENOMONEE FALLS, WI 53051
Waukesha County (414) 777-7097
MS. SUZANNE E. MOSER LCSW
Social Worker (Clinical)
W129N7055 NORTHFIELD DR
MENOMONEE FALLS, WI 53051
Waukesha County (414) 805-3666

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 Sumi Jones's NPI number?

The NPI number for Sumi Jones is 1467403204. It was assigned to this individual provider in the NPPES registry on May 15, 2006.

Where is Sumi Jones located?

Sumi Jones practices at W129n7055 Northfield Dr, Menomonee Falls, WI 53051. The listed phone number is (262) 253-5400.

What is Sumi Jones's specialty?

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

Is Sumi Jones enrolled in Medicare?

Yes. Sumi Jones 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.

What insurance does Sumi Jones accept?

Health plans from Anthem Blue Cross and Blue Shield and Network Health list Sumi Jones 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 Sumi Jones affiliated with any hospitals?

According to CMS data, Sumi Jones is affiliated with Community Memorial Hospital and Froedtert Memorial Lutheran Hospital.

When was this NPI record last updated?

The NPPES record for Sumi Jones was last updated on January 17, 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.