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ENRIQUE JOSE PACHECO SUMOZA M.D.
NPI 1649666983
Internal Medicine - Pulmonary Disease in Philadelphia, PA

Active since April 14, 2015PECOS EnrolledAccepts Medicare Assignment
5501 OLD YORK RD, PHILADELPHIA, PA 19141(215) 456-6950(215) 456-1766 Get Directions Write a Review

NPPES record last updated: July 15, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 15, 2024, Jul 3, 2021, Feb 26, 2021 and 1 more (4 updates tracked since 2018).

About Enrique Jose Pacheco Sumoza M.d. NPPES

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

ENRIQUE JOSE PACHECO SUMOZA M.D. (NPI 1649666983) is an individual pulmonary disease provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD485522) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, is affiliated with Albert Einstein Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1649666983
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameENRIQUE JOSE PACHECO SUMOZACredential: M.D.
Location Address5501 OLD YORK RDPhiladelphia, PA 19141-3018
Mailing Address101 E Olney Ave Ste 400Philadelphia, PA 19120-2470 · (215) 456-7000 · Fax (215) 456-5926
Phone(215) 456-6950
Fax(215) 456-1766
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateApril 14, 2015
Last NPPES UpdateJuly 15, 20244 updates tracked since enumeration
NPPES CertifiedJuly 3, 2024
✔ NPI 1649666983 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in PA · MD485522
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal MedicineTaxonomy 207R00000X · License 60370 (CT)
Also ListedHospitalistTaxonomy 208M00000X · License 60370 (CT)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
5501 OLD YORK RD, Philadelphia, PA 19141
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1160 Robbins StWaterbury, CT 06708 · Phone (203) 573-7284 · Fax (203) 573-7031
Location 217 Davis Blvd Ste 308Tampa, FL 33606-3438 · Phone (813) 974-2201

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.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

Enrique Jose Pacheco Sumoza 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 ID8224327911
PECOS Enrollment IDI20240806000709
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 Reassignment

Medicare enrollment records show Enrique Pacheco Sumoza reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Einstein Practice Plan, Inc
Same address
Medical Toxicology
5501 OLD YORK RD
Philadelphia, PA 19141
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 1,205 clinicians in this Medicare group
NPI 1396327151 (215) 456-6666

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.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
75 services31 patients
Test to measure expiratory airflow and volume changes before and after medication administration 94060
This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.
23 services23 patients
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.
20 services14 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.
18 services11 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.
17 services17 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
16 services16 patients

Hospital Affiliations CMS Care Compare

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

Albert Einstein Medical Center

Acute Care Hospitals · Philadelphia, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390142
Location5501 Old York RoadPhiladelphia, PA 19141 · Philadelphia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19141 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
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
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 20

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

KENNETH KLECKNER MD
Emergency Medicine
5501 OLD YORK RD, EINSTEIN MEDICAL CENTER - PHILADELPHIA
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-6679
MS. AMMAN HASSAN MD
Pediatrics
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-3810
TAYLOR NICOLE THOMPSON PA-C
Physician Assistant (Medical)
5501 OLD YORK RD, KORMAN BUILDING SUITE 202
PHILADELPHIA, PA 19141
Philadelphia County (215) 254-2630
STEPHEN RYAN CHEN
Orthopaedic Surgery
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
DR. DHRUV SHARMA MD
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
TIMOTHY DANIEL GARDNER DO
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
DR. JONATHAN THOMAS LUCIANI DO
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
ASHIKA KAPOOR MD
Psychiatry & Neurology (Psychiatry)
5501 OLD YORK RD
PHILA, PA 19141
Philadelphia County (215) 456-8103

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 Enrique Pacheco Sumoza's NPI number?

The NPI number for Enrique Pacheco Sumoza is 1649666983. It was assigned to this individual provider in the NPPES registry on April 14, 2015.

Where is Enrique Pacheco Sumoza located?

Enrique Pacheco Sumoza practices at 5501 Old York Rd, Philadelphia, PA 19141. The listed phone number is (215) 456-6950.

What is Enrique Pacheco Sumoza's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Enrique Pacheco Sumoza enrolled in Medicare?

Yes. Enrique Pacheco Sumoza 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 Enrique Pacheco Sumoza's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Enrique Pacheco Sumoza reassigns Medicare benefits to Einstein Practice Plan, Inc (Philadelphia, PA). 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 Enrique Pacheco Sumoza's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Enrique Pacheco Sumoza accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Enrique Pacheco Sumoza 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 Enrique Pacheco Sumoza affiliated with any hospitals?

According to CMS data, Enrique Pacheco Sumoza is affiliated with Albert Einstein Medical Center.

When was this NPI record last updated?

The NPPES record for Enrique Pacheco Sumoza was last updated on July 15, 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.