SUMAIYA MAHBOOB MD
NPI 1558855502
Internal Medicine in Great Falls, MT

Active since June 21, 2018PECOS EnrolledAccepts Medicare Assignment
80.46/100
CMS Quality Rating
1101 26TH ST S, GREAT FALLS, MT 59405(406) 455-5000(406) 731-8318 Get Directions Write a Review

NPPES record last updated: April 8, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 8, 2024, Sep 16, 2021, Mar 19, 2021 and 1 more (4 updates tracked since 2018).

About Sumaiya Mahboob Md NPPES

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

SUMAIYA MAHBOOB MD (NPI 1558855502) is an individual internal medicine provider in Great Falls, Montana, licensed in Montana (96228) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS, is affiliated with Benefis Hospitals Inc, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1558855502
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameSUMAIYA MAHBOOBCredential: MD
Location Address1101 26TH ST SGreat Falls, MT 59405-5161
Mailing Address1101 26th St SGreat Falls, MT 59405-5161 · (406) 455-5000 · Fax (406) 731-8318
Fax(406) 731-8318
Sole ProprietorYes
Medical School CMSOtherGraduated 2014
Enumeration DateJune 21, 2018
Last NPPES UpdateApril 8, 20244 updates tracked since enumeration
NPPES CertifiedApril 8, 2024
NPI 1558855502 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in MT · 96228
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.
1101 26TH ST S, Great Falls, MT 59405

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

Sumaiya Mahboob 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 ID4284986480
PECOS Enrollment IDI20210930001159
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 5

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.

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.
409 services175 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.
189 services95 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
144 services142 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
58 services30 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.
28 services28 patients

Hospital Affiliations CMS Care Compare

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

Benefis Hospitals Inc

Acute Care Hospitals · Great Falls, MT
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number270012
Location1101 26th St SGreat Falls, MT 59405 · Cascade County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 59405 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
$130.52 typical visit price
range $56.81 – $172.26
Typical copayment $32.63 (range $14.20 – $43.06)
Most-billed visit code 99204
Established Patient
$100.16 typical visit price
range $18.24 – $140.32
Typical copayment $25.04 (range $4.56 – $35.08)
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.

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.

80.46/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality93.1
Promoting Interoperability75
Improvement Activities40
Cost62.61

Referred Medical Equipment & Supplies CMS DME claims 2

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

Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034
Other-Enteral and Parenteral · category OB006N
1 supplier11 claims306 services$3.26 avg. paid by Medicare
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152
Other-Enteral and Parenteral · category OB006N
1 supplier12 claims5,449 services$0.28 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.

Hospitalist
1101 26TH ST S
GREAT FALLS, MT 59405
Internal Medicine (Clinical Cardiac Electrophysiology)
1101 26TH ST S
GREAT FALLS, MT 59405
Occupational Therapy Assistant
1101 26TH ST S
GREAT FALLS, MT 59405
Occupational Therapist
1101 26TH ST S
GREAT FALLS, MT 59405
Neurological Surgery
1101 26TH ST S
GREAT FALLS, MT 59405
Nurse Practitioner (Family)
1101 26TH ST S
GREAT FALLS, MT 59405
Pharmacist
1101 26TH ST S
GREAT FALLS, MT 59405
Radiology (Diagnostic Radiology)
1101 26TH ST S
GREAT FALLS, MT 59405

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 Sumaiya Mahboob's NPI number?

The NPI number for Sumaiya Mahboob is 1558855502. It was assigned to this individual provider in the NPPES registry on June 21, 2018.

Where is Sumaiya Mahboob located?

Sumaiya Mahboob practices at 1101 26th St S, Great Falls, MT 59405. The listed phone number is (406) 455-5000.

What is Sumaiya Mahboob's specialty?

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

Is Sumaiya Mahboob enrolled in Medicare?

Yes. Sumaiya Mahboob 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 Sumaiya Mahboob accept?

Health plans from Blue Cross and Blue Shield of Montana and Providence Health Plan list Sumaiya Mahboob 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 Sumaiya Mahboob affiliated with any hospitals?

According to CMS data, Sumaiya Mahboob is affiliated with Benefis Hospitals Inc.

When was this NPI record last updated?

The NPPES record for Sumaiya Mahboob was last updated on April 8, 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.