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PETER EVERETT SUGARBAKER
NPI 1609432186
Family Medicine - Sports Medicine in Phillipsburg, NJ

Active since May 10, 2019PECOS EnrolledAccepts Medicare Assignment
222 RED SCHOOL LN, PHILLIPSBURG, NJ 08865(908) 760-3211(908) 760-3212 Get Directions Write a Review

NPPES record last updated: September 1, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 1, 2023, Jun 2, 2023, May 10, 2019 (3 updates tracked since 2019).

About Peter Everett Sugarbaker NPPES

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

PETER EVERETT SUGARBAKER (NPI 1609432186) is an individual sports medicine provider in Phillipsburg, New Jersey, licensed in New Jersey (25MB11868200) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS, is affiliated with St Lukes Quakertown Hospital, and is a graduate of Lake Erie College Of Osteopathic Medicine, Erie (2019).

NPPES Registry Identity

NPI1609432186
Entity TypeIndividualMale
Primary Taxonomy207QS0010X
Provider Legal NamePETER EVERETT SUGARBAKER
Location Address222 RED SCHOOL LNPhillipsburg, NJ 08865-2219
Mailing AddressPo Box 416457Boston, MA 02241-6457 · (844) 362-1735
Phone(908) 760-3211
Fax(908) 760-3212
Sole ProprietorNo
Medical School CMSLake Erie College Of Osteopathic Medicine, ErieGraduated 2019
Enumeration DateMay 10, 2019
Last NPPES UpdateSeptember 1, 20233 updates tracked since enumeration
NPPES CertifiedSeptember 1, 2023
✔ NPI 1609432186 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
License✔ Licensed in NJ · 25MB11868200
Definition
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Also ListedFamily MedicineTaxonomy 207Q00000X · License OS021398 (PA)
222 RED SCHOOL LN, Phillipsburg, NJ 08865
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.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

Peter Everett Sugarbaker 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 ID8527429190
PECOS Enrollment IDI20230811002690
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.

Medicare Billing Reassignments

8

Medicare enrollment records show Peter Sugarbaker reassigns Medicare billing to 8 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

St Lukes Hospital
3.2 mi
Urgent Care
2003 SULLIVAN TRL
Easton, PA 18040
  • Reassigned Medicare billing, Pennsylvania enrollment
  • Medicare enrollment name: St Luke's Hospital
  • 128 clinicians in this Medicare group
NPI 1508343906 (484) 526-4000
St. Luke's Hosptial
12 mi
Urgent Care
487 E MOORESTOWN RD
Wind Gap, PA 18091
  • Reassigned Medicare billing, Pennsylvania enrollment
  • Medicare enrollment name: St Lukes Hospital-Anderson Campus
  • 104 clinicians in this Medicare group
NPI 1376965731 (484) 526-7850
St. Luke's Hospital Monroe Campus
19 mi
Urgent Care
111 ROUTE 715 STE 102
Brodheadsville, PA 18322
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 106 clinicians in this Medicare group
NPI 1831618560 (272) 212-0420
St. Luke's Quakertown Hospital
21 mi
Emergency Medicine
1021 PARK AVE
Quakertown, PA 18951
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 128 clinicians in this Medicare group
NPI 1033296157 (215) 538-4561
The Carbon Schuylkill Community Hospital, Inc.
30 mi
Urgent Care
575 S 9TH ST STE 7
Lehighton, PA 18235
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 145 clinicians in this Medicare group
NPI 1386185452 (570) 645-1000
Signify Health Medical Associates Of New Jersey, LLC
38 mi
General Practice
116 VILLAGE BLVD STE 200
Princeton, NJ 08540
  • Reassigned Medicare billing, New Jersey enrollment
  • 421 clinicians in this Medicare group
NPI 1174187728 (877) 868-5351
Gsl Hospital
56 mi
Urgent Care
2650 WOODGLEN RD
Pottsville, PA 17901
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 90 clinicians in this Medicare group
NPI 1073256608 (484) 526-1000
Signify Health Medical Associates, PLLC
1,311 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 553 clinicians in this Medicare group
NPI 1750845863 (972) 715-3800

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 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.

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.
116 services70 patients
Aspiration and/or injection of fluid large joint using ultrasound guidance 20611
This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.
67 services37 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
40 services40 patients
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.
19 services13 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
17 services17 patients

Hospital Affiliations CMS Care Compare 5

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

St Lukes Quakertown Hospital

Acute Care Hospitals · Quakertown, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390035
Location3000 St. Luke's DriveQuakertown, PA 18951 · Bucks County
Emergency services Birthing friendly

St Luke's Hospital Bethlehem

Acute Care Hospitals · Bethlehem, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390049
Location801 Ostrum StreetBethlehem, PA 18015 · Northampton County
Emergency services Birthing friendly

St Luke's Miners Memorial Hospital

Acute Care Hospitals · Coaldale, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390183
Location360 W Ruddle StreetCoaldale, PA 18218 · Schuylkill County
Emergency services

St Luke's Hospital - Monroe Campus

Acute Care Hospitals · Stroudsburg, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390330
Location100 St Luke's LaneStroudsburg, PA 18360 · Monroe County
Emergency services

Geisinger St. Luke's Hospital

Acute Care Hospitals · Orwigsburg, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390332
Location100 Paramount BoulevardOrwigsburg, PA 17961 · Schuylkill County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08865 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
$98.09 typical visit price
range $63.84 – $190.92
Typical copayment $24.52 (range $15.96 – $47.73)
Most-billed visit code 99203
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
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.

Other Providers at the Same Location NPPES 9

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

PROFESSIONAL ANESTHESIA SERVICES OF NEW JERSEY PC
Anesthesiology
222 RED SCHOOL LN
PHILLIPSBURG, NJ 08865
Warren County (877) 247-8080
COORDINATED HEALTH OF GREATER NEW JERSEY, LLC
Family Medicine
222 RED SCHOOL LN
PHILLIPSBURG, NJ 08865
Warren County (610) 861-8080
DR. JAMES HENRY REID MD
Orthopaedic Surgery
222 RED SCHOOL LN
PHILLIPSBURG, NJ 08865
Warren County (908) 760-3211
COORDINATED HEALTH OF GREATER NEW JERSEY LLC
Orthopaedic Surgery
222 RED SCHOOL LN
PHILLIPSBURG, NJ 08865
Warren County (610) 861-8080
MOHAMED SOHAIL DURRANI MD
Internal Medicine
222 RED SCHOOL LN
PHILLIPSBURG, NJ 08865
Warren County (908) 760-3203
COORDINATED HEALTH NJ, PC
Orthopaedic Surgery
222 RED SCHOOL LN
PHILLIPSBURG, NJ 08865
Warren County (610) 861-8080
APRIL LYNN SMITH PA C
Physician Assistant
222 RED SCHOOL LN
PHILLIPSBURG, NJ 08865
Warren County (908) 760-3211
LVHN COORDINATED PROFESSIONAL PRACTICE OF NJ, PC
Orthopaedic Surgery
222 RED SCHOOL LN
PHILLIPSBURG, NJ 08865
Warren County (610) 861-8080

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 Peter Sugarbaker's NPI number?

The NPI number for Peter Sugarbaker is 1609432186. It was assigned to this individual provider in the NPPES registry on May 10, 2019.

Where is Peter Sugarbaker located?

Peter Sugarbaker practices at 222 Red School Ln, Phillipsburg, NJ 08865. The listed phone number is (908) 760-3211.

What is Peter Sugarbaker's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Peter Sugarbaker enrolled in Medicare?

Yes. Peter Sugarbaker 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 organizations bill Medicare for Peter Sugarbaker's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Peter Sugarbaker reassigns Medicare benefits to 8 organizations: St Lukes Hospital (Easton, PA), St. Luke's Hosptial (Wind Gap, PA), St. Luke's Hospital Monroe Campus (Brodheadsville, PA), St. Luke's Quakertown Hospital (Quakertown, PA), The Carbon Schuylkill Community Hospital, Inc. (Lehighton, PA) and 3 more organizations, listed in the Medicare section above. Each 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 Peter Sugarbaker's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Peter Sugarbaker accept?

Health plans from Oscar Health list Peter Sugarbaker 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 Peter Sugarbaker affiliated with any hospitals?

According to CMS data, Peter Sugarbaker is affiliated with St Lukes Quakertown Hospital, St Luke's Hospital Bethlehem, St Luke's Miners Memorial Hospital, St Luke's Hospital - Monroe Campus and Geisinger St. Luke's Hospital.

When was this NPI record last updated?

The NPPES record for Peter Sugarbaker was last updated on September 1, 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.