THOMAS J SUGARMAN M.D
NPI 1609895903
Emergency Medicine in Antioch, CA
About Thomas J Sugarman M.d NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
THOMAS J SUGARMAN M.D (NPI 1609895903) is an individual emergency medicine provider in Antioch, California, licensed in Illinois (036084355) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Ascension St Vincent Clay, and is a graduate of Other (1992).
NPPES Registry Identity
Specialties & Licenses
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
Thomas J Sugarman 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.
Medicare Billing Reassignments
4Medicare enrollment records show Thomas Sugarman reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Antioch, CA 94509
- Reassigned Medicare billing, California enrollment
- 2,323 clinicians in this Medicare group
Belleville, IL 62226
- Reassigned Medicare billing, Illinois enrollment
- 982 clinicians in this Medicare group
Oconto Falls, WI 54154
- Reassigned Medicare billing, Wisconsin enrollment
- 104 clinicians in this Medicare group
Munster, IN 46321
- Reassigned Medicare billing, Indiana enrollment
- 598 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 3
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.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Ascension St Vincent Clay
Critical Access Hospitals · Brazil, INAscension St Vincent Salem
Critical Access Hospitals · Salem, INPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 94509 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.
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.
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 Thomas Sugarman's NPI number?
The NPI number for Thomas Sugarman is 1609895903. It was assigned to this individual provider in the NPPES registry on July 18, 2006.
Where is Thomas Sugarman located?
Thomas Sugarman practices at 3901 Lone Tree Way, Antioch, CA 94509. The listed phone number is (925) 779-7273.
What is Thomas Sugarman's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Thomas Sugarman enrolled in Medicare?
Yes. Thomas Sugarman 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 Thomas Sugarman's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Thomas Sugarman reassigns Medicare benefits to 4 organizations: Cep America - California (Antioch, CA), Cepamerica Illinois LLP (Belleville, IL), Vituity-Wisconsin Em Sc (Oconto Falls, WI) and Cep America LLC (Munster, IN). 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 Thomas Sugarman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Thomas Sugarman accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter from Meridian list Thomas Sugarman 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 Thomas Sugarman affiliated with any hospitals?
According to CMS data, Thomas Sugarman is affiliated with Ascension St Vincent Clay and Ascension St Vincent Salem.
When was this NPI record last updated?
The NPPES record for Thomas Sugarman was last updated on June 18, 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.
# Thomas J Sugarman, M.D · NPI 1609895903
Emergency Medicine physician in Antioch, California. Individual provider, active in the CMS NPPES registry since July 18, 2006.
## Identity
- **NPI:** 1609895903 (Entity type: Individual)
- **Enumerated:** July 18, 2006
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 036084355 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 3901 LONE TREE WAY, Antioch, CA 94509-6200
- **Phone:** (925) 779-7273
## 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:** 4 organizations under Medicare reassignment (form CMS-855R): Cep America - California (NPI 1912930421, Antioch, CA); Cepamerica Illinois LLP (NPI 1992082689, Belleville, IL); Vituity-Wisconsin Em Sc (NPI 1710754296, Oconto Falls, WI); Cep America LLC (NPI 1518623743, Munster, IN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1992
## Record status
- **NPPES last updated:** June 18, 2024
- **Other identifiers:** Medicaid 00G705520 (CA)
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Source: [NPI Profile](https://npiprofile.com/npi/1609895903) · Data from the CMS NPPES public registry.