DR. SEAN MICHAEL SUMSION M.D.
NPI 1538504469
Ophthalmology in Redding, CA

Active since May 06, 2013PECOS EnrolledAccepts Medicare Assignment
92.51/100
CMS Quality Rating
2801 PARK MARINA DR, REDDING, CA 96001(530) 244-2273(530) 244-2708 Get Directions Write a Review

NPPES record last updated: August 25, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 25, 2021, Mar 22, 2017, Oct 13, 2016 (3 updates tracked since 2016).

About Dr. Sean Michael Sumsion M.d. NPPES

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

DR. SEAN MICHAEL SUMSION M.D. (NPI 1538504469) is an individual ophthalmology provider in Redding, California, licensed in California (144812) and active in the NPI registry since May 2013. He is enrolled in Medicare PECOS and is a graduate of University Of California, Irvine, California College Of Medicine (2012).

NPPES Registry Identity

NPI1538504469
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. SEAN MICHAEL SUMSIONCredential: M.D.
Location Address2801 PARK MARINA DRRedding, CA 96001-2822
Mailing Address2801 Park Marina DrRedding, CA 96001-2822 · (530) 244-2273 · Fax (530) 244-2708
Fax(530) 244-2708
Sole ProprietorNo
Medical School CMSUniversity Of California, Irvine, California College Of MedicineGraduated 2012
Enumeration DateMay 6, 2013
Last NPPES UpdateAugust 25, 20213 updates tracked since enumeration
NPPES CertifiedAugust 25, 2021
NPI 1538504469 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses Licensed in CA · 144812 Licensed in TX · Q9748
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
2801 PARK MARINA DR, Redding, CA 96001

Accepted 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. Sean Michael Sumsion 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 ID5294021499
PECOS Enrollment IDI20170731000862
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 34

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.

Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
2,109 services966 patients
Injection, aflibercept, 1 mg J0178
Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.
1,634 services148 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
1,333 services196 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.
1,175 services403 patients
Analysis of substance using immunoassay technique, multiple step method 83516
This procedure involves the use of an immunoassay, a highly sensitive technique, to detect and measure substances in your body. It involves multiple steps and is commonly used in diagnosing and monitoring various health conditions.
1,157 services446 patients
Microfluid analysis of tears 83861
Microfluid analysis of tears involves collecting a small tear sample to examine its composition. This procedure can help detect health issues like dry eye disease, inflammation, or other eye conditions. It's a non-invasive, painless method for monitoring eye health.
1,129 services437 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 96001 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
$133.94 typical visit price
range $58.87 – $176.60
Typical copayment $33.48 (range $14.71 – $44.15)
Most-billed visit code 99204
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
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.

92.51/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40
Cost75.06

Other Providers at the Same Location NPPES 7

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

Eyewear Supplier
2801 PARK MARINA DR
REDDING, CA 96001
Optometrist
2801 PARK MARINA DR
REDDING, CA 96001
Ophthalmology
2801 PARK MARINA DR
REDDING, CA 96001
Optometrist
2801 PARK MARINA DR
REDDING, CA 96001
Ophthalmology
2801 PARK MARINA DR
REDDING, CA 96001
Ophthalmology
2801 PARK MARINA DR
REDDING, CA 96001
Clinic/Center (Ambulatory Surgical)
2801 PARK MARINA DR
REDDING, CA 96001

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 Sean Sumsion's NPI number?

The NPI number for Sean Sumsion is 1538504469. It was assigned to this individual provider in the NPPES registry on May 6, 2013.

Where is Sean Sumsion located?

Sean Sumsion practices at 2801 Park Marina Dr, Redding, CA 96001. The listed phone number is (530) 244-2273.

What is Sean Sumsion's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Sean Sumsion enrolled in Medicare?

Yes. Sean Sumsion 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 Sean Sumsion accept?

Health plans from Providence Health Plan list Sean Sumsion 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 Sean Sumsion was last updated on August 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.