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DR. MICHAEL BENJAMIN SUMNER JR. MD
NPI 1528250388
Internal Medicine in Augusta, GA

Active since August 15, 2007PECOS EnrolledAccepts Medicare Assignment
1120 15TH ST # BI-5070, AUGUSTA, GA 30912(706) 721-2423 Get Directions Write a Review

NPPES record last updated: June 23, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Michael Benjamin Sumner Jr. Md NPPES

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

DR. MICHAEL BENJAMIN SUMNER JR. MD (NPI 1528250388) is an individual internal medicine provider in Augusta, Georgia, licensed in Georgia (063062) and active in the NPI registry since August 2007. He is enrolled in Medicare PECOS, is affiliated with Washington County Regional Medical Center, and is a graduate of Medical College Of Georgia School Of Medicine (2003).

NPPES Registry Identity

NPI1528250388
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. MICHAEL BENJAMIN SUMNER JR.Credential: MD
Location Address1120 15TH ST # BI-5070Augusta, GA 30912-0004
Mailing Address1499 Walton Way, Suite 1400Augusta, GA 30901-2602 · (706) 828-8402
Phone(706) 721-2423
Sole ProprietorNo
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 2003
Enumeration DateAugust 15, 2007
Last NPPES UpdateJune 23, 2011
✔ NPI 1528250388 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in GA · 063062
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.
1120 15TH ST # BI-5070, Augusta, GA 30912
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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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Michael Benjamin Sumner Jr. 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 ID7315085107
PECOS Enrollment IDI20091116000540
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 10

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.

Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
103 services88 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.
85 services74 patients
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.
80 services54 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.
63 services42 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
23 services17 patients
Nursing facility discharge day management, 30 minutes or less 99315
Nursing facility discharge day management involves organizing your transition from the nursing facility to your home or another facility. This service, taking 30 minutes or less, includes finalizing medical instructions, arranging follow-up care, and answering any questions.
21 services21 patients

Hospital Affiliations CMS Care Compare 2

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

Washington County Regional Medical Center

Acute Care Hospitals · Sandersville, GA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110086
Location610 Sparta RoadSandersville, GA 31082 · Washington County
Emergency services

Burke Medical Center

Acute Care Hospitals · Waynesboro, GA
OwnershipProprietary
CMS Certification Number110113
Location351 South Liberty StreetWaynesboro, GA 30830 · Burke County

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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
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.

Referred Medical Equipment & Supplies CMS DME claims 6

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress E0261
DME-Hospital Beds · category DB000N
1 supplier13 claims13 services$35.08 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers43 claims43 services$17.60 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
2 suppliers43 claims43 services$102.62 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
3 suppliers25 claims25 services$21.07 avg. paid by Medicare
Lightweight wheelchair K0003
DME-Wheelchairs · category DD000N
1 supplier32 claims32 services$22.03 avg. paid by Medicare
Elevating leg rests, pair (for use with capped rental wheelchair base) K0195
DME-Wheelchairs · category DD021N
2 suppliers40 claims40 services$5.96 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Michael Sumner's NPI number?

The NPI number for Michael Sumner is 1528250388. It was assigned to this individual provider in the NPPES registry on August 15, 2007.

Where is Michael Sumner located?

Michael Sumner practices at 1120 15th St # Bi-5070, Augusta, GA 30912. The listed phone number is (706) 721-2423.

What is Michael Sumner's specialty?

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

Is Michael Sumner enrolled in Medicare?

Yes. Michael 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.

What insurance does Michael Sumner accept?

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

Is Michael Sumner affiliated with any hospitals?

According to CMS data, Michael Sumner is affiliated with Washington County Regional Medical Center and Burke Medical Center.

When was this NPI record last updated?

The NPPES record for Michael Sumner was last updated on June 23, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.