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DHIVYA SUGUMAR MD
NPI 1780942649
Internal Medicine in Gilbert, AZ

Active since April 30, 2012PECOS EnrolledAccepts Medicare Assignment
81.49/100
CMS Quality Rating
2940 E. BANNER GATEWAY DRIVE, SUITE 450, GILBERT, AZ 85234(480) 256-6444(480) 256-3359 Get Directions Write a Review

NPPES record last updated: September 27, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 27, 2018, Sep 20, 2016 (2 updates tracked since 2016).

About Dhivya Sugumar Md NPPES

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

DHIVYA SUGUMAR MD (NPI 1780942649) is an individual internal medicine provider in Gilbert, Arizona, licensed in Arkansas (E-9801) and active in the NPI registry since April 2012. She is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1780942649
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDHIVYA SUGUMARCredential: MD
Location Address2940 E. BANNER GATEWAY DRIVE, SUITE 450Gilbert, AZ 85234
Mailing Address2940 E. Banner Gateway Drive, Suite 450Gilbert, AZ 85234 · (480) 256-6444 · Fax (480) 256-3359
Phone(480) 256-6444
Fax(480) 256-3359
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateApril 30, 2012
Last NPPES UpdateSeptember 27, 20182 updates tracked since enumeration
✔ NPI 1780942649 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in AR · E-9801
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2940 E. BANNER GATEWAY DRIVE, Gilbert, AZ 85234
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Blue Cross Blue Shield of Arizona and more.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

Dhivya Sugumar 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.

PECOS PAC ID3971896846
PECOS Enrollment IDI20180827002610
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 Dhivya Sugumar reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Banner Cancer Center Specialists LLC
21 mi
Oncology
2901 N CENTRAL AVE STE 160
Phoenix, AZ 85012
  • Reassigned Medicare billing, Arizona enrollment
  • 470 clinicians in this Medicare group
NPI 1518253152 (602) 747-4000

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.

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
70 services70 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.
66 services52 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.
44 services39 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.
21 services17 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.
15 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85234 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
$127.71 typical visit price
range $55.44 – $168.60
Typical copayment $31.92 (range $13.86 – $42.15)
Most-billed visit code 99204
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
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.

81.49/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability100
Improvement Activities40
Cost38.3

Other Providers at the Same Location NPPES 2

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

HANNAH A LAWTHER MD
Radiology (Diagnostic Radiology)
2940 E. BANNER GATEWAY DRIVE, SUITE 350
GILBERT, AZ 85234
Maricopa County (480) 256-6444
JENNIFER CERNA NP
Nurse Practitioner
2940 E. BANNER GATEWAY DRIVE, SUITE 400
GILBERT, AZ 85234
Maricopa County (480) 256-6444

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 Dhivya Sugumar's NPI number?

The NPI number for Dhivya Sugumar is 1780942649. It was assigned to this individual provider in the NPPES registry on April 30, 2012.

Where is Dhivya Sugumar located?

Dhivya Sugumar practices at 2940 E. Banner Gateway Drive Suite 450, Gilbert, AZ 85234. The listed phone number is (480) 256-6444.

What is Dhivya Sugumar's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Dhivya Sugumar enrolled in Medicare?

Yes. Dhivya Sugumar 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 Dhivya Sugumar's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dhivya Sugumar reassigns Medicare benefits to Banner Cancer Center Specialists LLC (Phoenix, AZ). 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 Dhivya Sugumar's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dhivya Sugumar accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc. and UnitedHealthcare list Dhivya Sugumar 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.

When was this NPI record last updated?

The NPPES record for Dhivya Sugumar was last updated on September 27, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.