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ILIA ROSA SUMOZA MD
NPI 1548447113
Internal Medicine - Hematology & Oncology in Fenton, MO

Active since January 25, 2008PECOS EnrolledAccepts Medicare Assignment
1011 BOWLES AVE, SUITE G 50, FENTON, MO 63026(636) 496-4640(636) 496-4962 Get Directions Write a Review

NPPES record last updated: December 20, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ilia Rosa Sumoza Md NPPES

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

ILIA ROSA SUMOZA MD (NPI 1548447113) is an individual hematology & oncology provider in Fenton, Missouri, licensed in Missouri (2011030407) and active in the NPI registry since January 2008. She is enrolled in Medicare PECOS, is affiliated with Advocate Illinois Masonic Medical Center, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1548447113
Entity TypeIndividualFemale
Primary Taxonomy207RH0003X
Provider Legal NameILIA ROSA SUMOZACredential: MD
Location Address1011 BOWLES AVE, SUITE G 50Fenton, MO 63026-2395
Mailing Address1011 Bowles Ave, Suite G 50Fenton, MO 63026-2395 · (636) 496-4640 · Fax (636) 496-4962
Phone(636) 496-4640
Fax(636) 496-4962
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateJanuary 25, 2008
Last NPPES UpdateDecember 20, 2021
NPPES CertifiedDecember 20, 2021
✔ NPI 1548447113 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
License✔ Licensed in MO · 2011030407
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
1011 BOWLES AVE, Fenton, MO 63026
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.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

Ilia Rosa Sumoza 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 ID2769659382
PECOS Enrollment IDI20180820002009
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 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.
353 services221 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
351 services115 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.
91 services47 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.
70 services63 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
42 services29 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.
35 services34 patients

Hospital Affiliations CMS Care Compare 4

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

Advocate Illinois Masonic Medical Center

Acute Care Hospitals · Chicago, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140182
Location836 West Wellington AvenueChicago, IL 60657 · Cook County
Emergency services Birthing friendly

Advocate Christ Hospital & Medical Center

Acute Care Hospitals · Oak Lawn, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140208
Location4440 W 95th StreetOak Lawn, IL 60453 · Cook County
Emergency services Birthing friendly

Edward Hospital

Acute Care Hospitals · Naperville, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140231
Location801 South WashingtonNaperville, IL 60540 · Du Page County
Emergency services Birthing friendly

Advocate Good Samaritan Hospital

Acute Care Hospitals · Downers Grove, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140288
Location3815 Highland AvenueDowners Grove, IL 60515 · Du Page County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63026 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
$169.38 typical visit price
range $55.65 – $169.38
Typical copayment $42.34 (range $13.91 – $42.34)
Most-billed visit code 99205
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
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 3

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

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
1 supplier12 claims12 services$67.60 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$32.37 avg. paid by Medicare
Temozolomide, oral, 5 mg J8700
Treatment-Treatment - Miscellaneous · category RX000N
1 supplier17 claims1,482 services$0.64 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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. LAWRENCE VINCENT BOVERI MD
Obstetrics & Gynecology
1011 BOWLES AVE, SUITE 215
FENTON, MO 63026
St. Louis County (636) 680-1960
CENTER FOR ADVANCED FOOT & ANKLE SURGERY, INC.
Durable Medical Equipment & Medical Supplies
1011 BOWLES AVE, SUITE 123
FENTON, MO 63026
St. Louis County (314) 991-3668
MS. LITA LAPINS FNP
Nurse Practitioner (Family)
1011 BOWLES AVE, SUITE 300
FENTON, MO 63026
St. Louis County (314) 238-9100
SSM MEDICAL GROUP
Internal Medicine
1011 BOWLES AVE, SUITE 300
FENTON, MO 63026
St. Louis County (636) 496-5000
ALLISON KATE BROWN FNP
Nurse Practitioner (Family)
1011 BOWLES AVE
FENTON, MO 63026
St. Louis County (314) 200-2713
MS. DENISE P BLACKBURN APRN, FNP-BC
Nurse Practitioner (Family)
1011 BOWLES AVE, SUITE G10
FENTON, MO 63026
St. Louis County (314) 965-9980
LAWRENCE G EVANS MD LLC
Orthopaedic Surgery
1011 BOWLES AVE, SUITE 400
FENTON, MO 63026
St. Louis County (314) 821-4884
MRS. TIFFANY SHANTA HAROLD APRN
Nurse Practitioner (Women's Health)
1011 BOWLES AVE
FENTON, MO 63026
St. Louis County (636) 496-5438

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 Ilia Sumoza's NPI number?

The NPI number for Ilia Sumoza is 1548447113. It was assigned to this individual provider in the NPPES registry on January 25, 2008.

Where is Ilia Sumoza located?

Ilia Sumoza practices at 1011 Bowles Ave Suite G 50, Fenton, MO 63026. The listed phone number is (636) 496-4640.

What is Ilia Sumoza's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Is Ilia Sumoza enrolled in Medicare?

Yes. Ilia Sumoza 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 Ilia Sumoza accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Ilia Sumoza 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 Ilia Sumoza affiliated with any hospitals?

According to CMS data, Ilia Sumoza is affiliated with Advocate Illinois Masonic Medical Center, Advocate Christ Hospital & Medical Center, Edward Hospital and Advocate Good Samaritan Hospital.

When was this NPI record last updated?

The NPPES record for Ilia Sumoza was last updated on December 20, 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.