DR. SUMIT NARAYANPRASAD FOGLA M.D
NPI 1467652347
Family Medicine in Augusta, GA

Q: What is Sumit Fogla's NPI number?

The NPI number for Sumit Fogla is 1467652347. It was assigned to this individual provider in the NPPES registry on July 19, 2007.

Q: What is Sumit Fogla's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Sumit Fogla was last updated on January 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since July 19, 2007PECOS Enrolled

1120 15TH ST, AUGUSTA, GA 30912(706) 721-8623(706) 721-1459 Get Directions Write a Review

NPPES record last updated: January 25, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 25, 2023, Jan 10, 2023, Oct 22, 2020 (3 updates tracked since 2020).

On this page

About Dr. Sumit Narayanprasad Fogla M.d NPPES

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

DR. SUMIT NARAYANPRASAD FOGLA M.D (NPI 1467652347) is an individual family medicine provider in Augusta, Georgia, licensed in Georgia (90357) and active in the NPI registry since July 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1467652347

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. SUMIT NARAYANPRASAD FOGLACredential: M.D

Location Address1120 15TH STAugusta, GA 30912-0004

Mailing Address1120 15th St, Or 6000Augusta, GA 30912-0004 · (706) 721-3813

Phone(706) 721-8623

Fax(706) 721-1459

Sole ProprietorNo

Enumeration DateJuly 19, 2007

Last NPPES UpdateJanuary 25, 20233 updates tracked since enumeration

NPPES CertifiedJanuary 25, 2023

✔ NPI 1467652347 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in GA · 90357✔ Licensed in MI · 4301085593

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 4301085593 (MI)

1120 15TH ST, Augusta, GA 30912

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health 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 (PECOS)

Dr. Sumit Narayanprasad Fogla M.d is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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

Medicare enrollment records show Sumit Fogla reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Au Medical Associates Inc

Same address

Multi-Specialty

1120 15TH ST
Augusta, GA 30912

Reassigned Medicare billing, Georgia enrollment
1,151 clinicians in this Medicare group

NPI 1841230620 (706) 721-2273

Wellstar Medical Group, LLC

140 mi

Family Medicine

11685 ALPHARETTA HWY, SUITE 300
Roswell, GA 30076

Reassigned Medicare billing, Georgia enrollment
3,885 clinicians in this Medicare group

NPI 1922405729 (678) 325-6611

Beaumont Medical Group- Specialty Services

627 mi

Surgery

3601 W 13 MILE RD
Royal Oak, MI 48073

Reassigned Medicare billing, Michigan enrollment
1,030 clinicians in this Medicare group

NPI 1578072906 (248) 898-5000

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 4

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.

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

380 services123 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

63 services43 patients

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.

55 services45 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

21 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30912 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.

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.

DR. TOYA HESTER KELLEY MD

Family Medicine

1120 15TH ST
AUGUSTA, GA 30912

Richmond County (706) 721-3157

DR. JACK BRADLEY ELLIS D.O.

Internal Medicine

1120 15TH ST
AUGUSTA, GA 30912

Richmond County (706) 721-8623

SAMI MOHAMMED ALSHEHRY

Student in an Organized Health Care Education/Training Program

1120 15TH ST, 1065
AUGUSTA, GA 30912

Richmond County (706) 721-2411

LUIS ALBERTO VELASQUEZ ZARATE M.D

Pathology (Anatomic Pathology & Clinical Pathology)

1120 15TH ST
AUGUSTA, GA 30912

Richmond County (706) 721-2771

DR. BRYAN RICHARD BROACH M.D.

Internal Medicine

1120 15TH ST
AUGUSTA, GA 30912

Richmond County (706) 721-8623

JANELLE MCGILL M.D.

Pediatrics

1120 15TH ST
AUGUSTA, GA 30912

Richmond County (706) 721-8623

DR. KAYLA ASHLEY SHAHBAZIAN DO

Internal Medicine

1120 15TH ST
AUGUSTA, GA 30912

Richmond County (706) 721-8623

ROSA MARIA LOPEZ RINCON

Anesthesiology

1120 15TH ST
AUGUSTA, GA 30912

Richmond County (706) 446-5836

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 Sumit Fogla's NPI number?

The NPI number for Sumit Fogla is 1467652347. It was assigned to this individual provider in the NPPES registry on July 19, 2007.

Where is Sumit Fogla located?

Sumit Fogla practices at 1120 15th St, Augusta, GA 30912. The listed phone number is (706) 721-8623.

What is Sumit Fogla's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sumit Fogla enrolled in Medicare?

Yes. Sumit Fogla is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Sumit Fogla's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sumit Fogla reassigns Medicare benefits to 3 organizations: Au Medical Associates Inc (Augusta, GA), Wellstar Medical Group, LLC (Roswell, GA) and Beaumont Medical Group- Specialty Services (Royal Oak, MI). 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 Sumit Fogla's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sumit Fogla accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 3 other insurers list Sumit Fogla 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 Sumit Fogla was last updated on January 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.