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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SUMI SEXTON M.D.
NPI 1649227521
Family Medicine in Arlington, VA

Active since May 27, 2006PECOS EnrolledAccepts Medicare Assignment
200 N GLEBE RD, STE 300, ARLINGTON, VA 22203(703) 243-1300(703) 243-1151 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Sumi Sexton M.d. NPPES

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

SUMI SEXTON M.D. (NPI 1649227521) is an individual family medicine provider in Arlington, Virginia, licensed in Virginia (0101222193) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Virginia Hospital Center, and is a graduate of University Of Miami, Lm Miller School Of Medicine (1996).

NPPES Registry Identity

NPI1649227521
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameSUMI SEXTONCredential: M.D.
Location Address200 N GLEBE RD, STE 300Arlington, VA 22203-3728
Mailing Address1822 N Ode StArlington, VA 22209-1410 · (703) 527-3875
Phone(703) 243-1300
Fax(703) 243-1151
Sole ProprietorNo
Medical School CMSUniversity Of Miami, Lm Miller School Of MedicineGraduated 1996
Enumeration DateMay 27, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1649227521 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in VA · 0101222193
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
200 N GLEBE RD, Arlington, VA 22203
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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

Sumi Sexton 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.

PECOS PAC ID4385815638
PECOS Enrollment IDI20111114000532, I20140709002492
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 10

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.
138 services85 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.
78 services67 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
53 services53 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.
52 services42 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
26 services26 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
23 services23 patients

Hospital Affiliations CMS Care Compare

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

Virginia Hospital Center

Acute Care Hospitals · Arlington, VA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490050
Location1701 North George Mason DriveArlington, VA 22205 · Arlington County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22203 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
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
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.

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
97%2,778 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
80%147 patients4/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
87%177 patients2/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
59%1,458 patients3/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%1,368 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
72%1,368 patients4/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
77%1,368 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

RADHA SRIPATHY SHANKAR PH.D.
Psychologist
200 N GLEBE RD, SUITE 1050
ARLINGTON, VA 22203
Arlington County (703) 258-2243
CATHOLIC CHARITIES
Community/Behavioral Health
200 N GLEBE RD, SUITE 250
ARLINGTON, VA 22203
Arlington County (703) 224-1648
MS. JENNIFER MARIE WALDEN LPC
Counselor (Addiction (Substance Use Disorder))
200 N GLEBE RD, SUITE 104
ARLINGTON, VA 22203
Arlington County (703) 841-0703
KELLEY S REED LCSW
Social Worker (Clinical)
200 N GLEBE RD
ARLINGTON, VA 22203
Arlington County (703) 841-0703
CARLENE FLYNN
Physical Therapist
200 N GLEBE RD
ARLINGTON, VA 22203
Arlington County (703) 527-1700
MR. MICHAEL JAMES O'CONNOR PT MS, DPT
Physical Therapist (Orthopedic)
200 N GLEBE RD, SUITE 310
ARLINGTON, VA 22203
Arlington County (703) 527-1700
COMPREHENSIVE SLEEP CARE CENTER INC
Internal Medicine (Sleep Medicine)
200 N GLEBE RD, SUITE 316
ARLINGTON, VA 22203
Arlington County (703) 729-3420
DONG-PHUONG T LY D.M.D.
Dentist
200 N GLEBE RD, SUITE 225
ARLINGTON, VA 22203
Arlington County (703) 248-1111

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 Sumi Sexton's NPI number?

The NPI number for Sumi Sexton is 1649227521. It was assigned to this individual provider in the NPPES registry on May 27, 2006.

Where is Sumi Sexton located?

Sumi Sexton practices at 200 N Glebe Rd Ste 300, Arlington, VA 22203. The listed phone number is (703) 243-1300.

What is Sumi Sexton's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sumi Sexton enrolled in Medicare?

Yes. Sumi Sexton 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.

Is Sumi Sexton affiliated with any hospitals?

According to CMS data, Sumi Sexton is affiliated with Virginia Hospital Center.

When was this NPI record last updated?

The NPPES record for Sumi Sexton was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 43 days 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.