SUMANA G SETTY MD
NPI 1710417563
Family Medicine in Boston, MA
About Sumana G Setty Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SUMANA G SETTY MD (NPI 1710417563) is an individual family medicine provider in Boston, Massachusetts, licensed in Massachusetts (285675) and active in the NPI registry since June 2017. She is enrolled in Medicare PECOS, is affiliated with Lawrence General Hospital, and maintains a secondary practice location in Lawrence.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 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
Sumana G Setty Md 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
6Medicare enrollment records show Sumana Setty reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Boston, MA 02118
- Reassigned Medicare billing, Massachusetts enrollment
- 113 clinicians in this Medicare group
Boston, MA 02118
- Reassigned Medicare billing, Massachusetts enrollment
- 158 clinicians in this Medicare group
Boston, MA 02118
- Reassigned Medicare billing, Massachusetts enrollment
- 195 clinicians in this Medicare group
East Boston, MA 02128
- Reassigned Medicare billing, Massachusetts enrollment
- 577 clinicians in this Medicare group
East Boston, MA 02128
- Reassigned Medicare billing, Massachusetts enrollment
- Medicare enrollment name: East Boston Neighborhood Health Center Corp
- 456 clinicians in this Medicare group
Lawrence, MA 01843
- Reassigned Medicare billing, Massachusetts enrollment
- 143 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 6
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.
Lawrence General Hospital
Acute Care Hospitals · Lawrence, MABoston Medical Center
Acute Care Hospitals · Boston, MAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 02118 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
BOSTON, MA 02118
BOSTON, MA 02118
BOSTON, MA 02118
BOSTON, MA 02118
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 Sumana Setty's NPI number?
The NPI number for Sumana Setty is 1710417563. It was assigned to this individual provider in the NPPES registry on June 14, 2017.
Where is Sumana Setty located?
Sumana Setty practices at 1 Boston Medical Center Place Dowling 5, Boston, MA 02118. The listed phone number is (617) 414-4465.
What is Sumana Setty's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Sumana Setty enrolled in Medicare?
Yes. Sumana Setty 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 Sumana Setty's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Sumana Setty reassigns Medicare benefits to 6 organizations: Boston University Family Medicine, Inc. (Boston, MA), Boston University Obstetrics And Gynecology Foundation, Inc. (Boston, MA), Child Health Foundation Of Boston, Inc. (Boston, MA), Internal Medical Associates-Ebnhc (East Boston, MA), Neighborhealth Corporation (East Boston, MA) and 1 more organization, 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 Sumana Setty's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Sumana Setty accept?
Health plans from Anthem Blue Cross and Blue Shield, Taro Health and WellSense Health Plan list Sumana Setty 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 Sumana Setty affiliated with any hospitals?
According to CMS data, Sumana Setty is affiliated with Lawrence General Hospital and Boston Medical Center.
When was this NPI record last updated?
The NPPES record for Sumana Setty was last updated on February 7, 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.
# Sumana G Setty, MD · NPI 1710417563
Family Medicine physician in Boston, Massachusetts. Individual provider, active in the CMS NPPES registry since June 14, 2017.
## Identity
- **NPI:** 1710417563 (Entity type: Individual)
- **Enumerated:** June 14, 2017
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 285675 (Massachusetts)
- **Sole proprietor:** No
## Practice location
- **Address:** 1 BOSTON MEDICAL CENTER PLACE, DOWLING 5, Boston, MA 02118-2908
- **Phone:** (617) 414-4465 · **Fax:** (617) 414-3345
## 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:** 6 organizations under Medicare reassignment (form CMS-855R): Boston University Family Medicine, Inc. (NPI 1134166390, Boston, MA); Boston University Obstetrics And Gynecology Foundation, Inc. (NPI 1063459568, Boston, MA); Child Health Foundation Of Boston, Inc. (NPI 1619969920, Boston, MA); Internal Medical Associates-Ebnhc (NPI 1558481879, East Boston, MA); Neighborhealth Corporation (NPI 1316994411, East Boston, MA); and 1 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** New York Medical College, class of 2017
## Record status
- **NPPES last updated:** February 7, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1710417563) · Data from the CMS NPPES public registry.