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SUMBUL ARSHAD ALI M.D.
NPI 1801032529
Internal Medicine - Endocrinology, Diabetes & Metabolism in Spring Hill, FL

Active since December 30, 2008PECOS EnrolledAccepts Medicare Assignment
14690 SPRING HILL DR STE 206, SPRING HILL, FL 34609(352) 799-4206(352) 799-4207 Get Directions Write a Review

NPPES record last updated: April 8, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 8, 2026, May 20, 2019, Jul 18, 2017 and 2 more (5 updates tracked since 2015).

About Sumbul Arshad Ali M.d. NPPES

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

SUMBUL ARSHAD ALI M.D. (NPI 1801032529) is an individual endocrinology, diabetes & metabolism provider in Spring Hill, Florida, licensed in Florida (ME120964) and active in the NPI registry since December 2008. She is enrolled in Medicare PECOS, is affiliated with Hca Florida Oak Hill Hospital, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1801032529
Entity TypeIndividualFemale
Primary Taxonomy207RE0101X
Provider Legal NameSUMBUL ARSHAD ALICredential: M.D.
Location Address14690 SPRING HILL DR STE 206Spring Hill, FL 34609-8102
Mailing Address5350 Spring Hill DrSpring Hill, FL 34606-4562 · (352) 277-5348 · Fax (352) 606-2857
Phone(352) 799-4206
Fax(352) 799-4207
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateDecember 30, 2008
Last NPPES UpdateApril 8, 20265 updates tracked since enumeration
NPPES CertifiedApril 8, 2026
✔ NPI 1801032529 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in FL · ME120964
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License BP10031155 (TX)
14690 SPRING HILL DR STE 206, Spring Hill, FL 34609
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Other Identifiers 2

Other150LRFL · Bcbs
Medicaid015120800FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), UnitedHealthcare.Insurance ›

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

Sumbul Arshad Ali 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 ID4486967924
PECOS Enrollment IDI20150713002758
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 4

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.
465 services233 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
250 services108 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
47 services47 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
11 services11 patients

Hospital Affiliations CMS Care Compare

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

Hca Florida Oak Hill Hospital

Acute Care Hospitals · Brooksville, FL
3/5 CMS rating
OwnershipProprietary
CMS Certification Number100264
Location11375 Cortez BlvdBrooksville, FL 34613 · Hernando County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34609 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
100%146 patients5/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
64%132 patients3/55-star benchmark: 100%
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.

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supplies for maintenance of insulin infusion catheter, per week A4224
DME-Other DME · category DE017N
4 suppliers31 claims430 services$17.78 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
4 suppliers28 claims970 services$2.23 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
17 suppliers56 claims256 services$6.33 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
9 suppliers14 claims25 services$1.15 avg. paid by Medicare
External ambulatory infusion pump, insulin E0784
DME-Other DME · category DE017N
3 suppliers21 claims21 services$324.36 avg. paid by Medicare
Insulin for administration through dme (i.e., insulin pump) per 50 units J1817
Treatment-Injections and Infusions (nononcologic) · category RI000N
7 suppliers19 claims2,560 services$6.66 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

JOHONNA GILBREATH ASQUITH M.D.
Internal Medicine (Infectious Disease)
14690 SPRING HILL DR STE 206
SPRING HILL, FL 34609
Hernando County (352) 799-4206

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 Sumbul Ali's NPI number?

The NPI number for Sumbul Ali is 1801032529. It was assigned to this individual provider in the NPPES registry on December 30, 2008.

Where is Sumbul Ali located?

Sumbul Ali practices at 14690 Spring Hill Dr Ste 206, Spring Hill, FL 34609. The listed phone number is (352) 799-4206.

What is Sumbul Ali's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Sumbul Ali enrolled in Medicare?

Yes. Sumbul Ali 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.

What insurance does Sumbul Ali accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and UnitedHealthcare list Sumbul Ali 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 Sumbul Ali affiliated with any hospitals?

According to CMS data, Sumbul Ali is affiliated with Hca Florida Oak Hill Hospital.

When was this NPI record last updated?

The NPPES record for Sumbul Ali was last updated on April 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.