SUMANTH BALGURI MD, FAAFP
NPI 1598077679
Family Medicine in Fort Smith, AR
About Sumanth Balguri Md, Faafp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SUMANTH BALGURI MD, FAAFP (NPI 1598077679) is an individual family medicine provider in Fort Smith, Arkansas, licensed in Arkansas (E-8115) and active in the NPI registry since July 2010. He is enrolled in Medicare PECOS, maintains a secondary practice location in Fort Smith, and is a graduate of Other (2007).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Sumanth Balguri Md, Faafp 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.
Medicare Billing Reassignment
Medicare enrollment records show Sumanth Balguri reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fort Smith, AR 72903
- Reassigned Medicare billing, Arkansas enrollment
- 658 clinicians in this Medicare group
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 9
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 72903 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
Reported Quality Measures
Referred Medical Equipment & Supplies CMS DME claims 4
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
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.
FORT SMITH, AR 72903
FORT SMITH, AR 72903
FORT SMITH, AR 72903
FORT SMITH, AR 72903
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 Sumanth Balguri's NPI number?
The NPI number for Sumanth Balguri is 1598077679. It was assigned to this individual provider in the NPPES registry on July 6, 2010.
Where is Sumanth Balguri located?
Sumanth Balguri practices at 7301 Rogers Ave, Fort Smith, AR 72903. The listed phone number is (479) 314-6030.
What is Sumanth Balguri's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Sumanth Balguri enrolled in Medicare?
Yes. Sumanth Balguri 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.
Which organization bills Medicare for Sumanth Balguri's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Sumanth Balguri reassigns Medicare benefits to Mercy Clinic Fort Smith Communities (Fort Smith, AR). The 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 Sumanth Balguri's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Sumanth Balguri accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Sumanth Balguri 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 Sumanth Balguri was last updated on July 10, 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.
# Sumanth Balguri, MD, FAAFP · NPI 1598077679
Family Medicine physician in Fort Smith, Arkansas. Individual provider, active in the CMS NPPES registry since July 6, 2010.
## Identity
- **NPI:** 1598077679 (Entity type: Individual)
- **Enumerated:** July 6, 2010
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** E-8115 (Arkansas)
- **Sole proprietor:** No
## Practice location
- **Address:** 7301 ROGERS AVE, Fort Smith, AR 72903-4100
- **Phone:** (479) 314-6030 · **Fax:** (479) 314-2021
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Mercy Clinic Fort Smith Communities (NPI 1902073620, Fort Smith, AR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2007
## Record status
- **NPPES last updated:** July 10, 2023
- **Other identifiers:** Medicaid 198945001 (AR)
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Source: [NPI Profile](https://npiprofile.com/npi/1598077679) · Data from the CMS NPPES public registry.