MR. SIDNEY MICHAEL SUTTON SR. MD
NPI 1811978158
Family Medicine in Elizabeth City, NC
Quality Rating: 95.11 out of 100 score
NPI Status: Active since November 11, 2005
Contact Information
1141 N ROAD ST STE G
ELIZABETH CITY, NC
ZIP 27909
Phone: (252) 337-9120
Fax: (855) 330-7320
- NPI Profile Information
- Primary Taxonomy
- Insurance Plans Accepted
- Medicare Participation & PECOS Status
- Areas of Expertise
- Durable Medical Equipment
- Physician Visit Costs
- Overall Quality Performance
- Hospital Affiliations - Privileges
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
- Individual
- Male
- Years of Experience 44
- Family Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About SIDNEY SUTTON
This page provides the complete NPI Profile along with additional information for Sidney Sutton, a primary care provider established in Elizabeth City, North Carolina with a medical specialization in Family Medicine and more than 44 years of experience. He graduated from Eastern Virginia Medical School in 1982. The healthcare provider is registered in the NPI registry with number 1811978158 assigned on November 2005. The practitioner's primary taxonomy code is 207Q00000X with license number 29045 (NC). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1811978158
- Provider Name
- MR. SIDNEY MICHAEL SUTTON SR. MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1141 N ROAD ST STE G ELIZABETH CITY, NC 27909
- Location Phone
- (252) 337-9120
- Location Fax
- (855) 330-7320
- Mailing Address
- 1141 N ROAD ST STE G ELIZABETH CITY, NC 27909
- Mailing Phone
- (252) 337-9120
- Mailing Fax
- (855) 330-7320
- Medical School Name
- EASTERN VIRGINIA MEDICAL SCHOOL
- Graduation Year
- 1982
- Is Sole Proprietor?
- No
- Enumeration Date
- 11-11-2005
- Last Update Date
- 12-06-2023
- Code Navigator
A primary care provider (PCP) like Sidney Sutton sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 29045
- License State
- NC
- Taxonomy Description
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Bronze HSA Eligible | Integrated | Nationwide Doctors - PPO
- Blue Advantage Bronze Standard | Nationwide Doctors - PPO
- Blue Advantage Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Gold Standard A | Nationwide Doctors - PPO
- Blue Advantage Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Silver Standard | Nationwide Doctors - PPO
- Blue Care Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Statewide Doctors - HMO
- Blue Care Bronze Complete | $60 PCP | $20 Tier 1 Rx | Statewide Doctors - HMO
- Blue Care Bronze HSA Eligible | Integrated | Statewide Doctors - HMO
- Blue Care Bronze Standard | Statewide Doctors - HMO
- Blue Care Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Statewide Doctors - HMO
- Blue Care Gold Standard A | Statewide Doctors - HMO
- Blue Care Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Statewide Doctors - HMO
- Blue Care Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Statewide Doctors - HMO
- Blue Care Silver Standard | Statewide Doctors - HMO
- Blue Value Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Limited Statewide Doctors - POS
- Blue Value Bronze Complete | $60 PCP | $20 Tier 1 Rx | Limited Statewide Doctors - POS
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Standard+ Dental + Vision (No Referrals) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Silver Standard (No Referrals) - HMO
- UHC Silver Value ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5900660 | MEDICAID (05) | NC |
Medicare Participation & PECOS Enrollment Status
Sidney Sutton is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Sidney Sutton is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 9032171996
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20090717000599
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
12 DME suppliers used 113 Medicare Claims 267 Services Paid
DME-Other DME (DE000N)
Normal, low and high calibrator solution / chips (HCPCS:A4256)
2 DME suppliers used 16 Medicare Claims 16 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Lancets, per box of 100 (HCPCS:A4259)
8 DME suppliers used 53 Medicare Claims 67 Services Paid
DME-Other DME (DE001N)
Full face mask used with positive airway pressure device, each (HCPCS:A7030)
2 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Other DME (DE001N)
Face mask interface, replacement for full face mask, each (HCPCS:A7031)
2 DME suppliers used 13 Medicare Claims 39 Services Paid
DME-Other DME (DE001N)
Cushion for use on nasal mask interface, replacement only, each (HCPCS:A7032)
2 DME suppliers used 11 Medicare Claims 63 Services Paid
DME-Other DME (DE001N)
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)
2 DME suppliers used 17 Medicare Claims 17 Services Paid
DME-Other DME (DE001N)
Headgear used with positive airway pressure device (HCPCS:A7035)
2 DME suppliers used 17 Medicare Claims 17 Services Paid
DME-Other DME (DE001N)
Tubing used with positive airway pressure device (HCPCS:A7037)
1 DME suppliers used 19 Medicare Claims 19 Services Paid
DME-Other DME (DE001N)
Filter, disposable, used with positive airway pressure device (HCPCS:A7038)
2 DME suppliers used 26 Medicare Claims 151 Services Paid
DME-Other DME (DE001N)
Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)
2 DME suppliers used 14 Medicare Claims 14 Services Paid
DME-Hospital Beds (DB000N)
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)
2 DME suppliers used 49 Medicare Claims 49 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
2 DME suppliers used 17 Medicare Claims 17 Services Paid
DME-Other DME (DE000N)
Nebulizer, with compressor (HCPCS:E0570)
2 DME suppliers used 19 Medicare Claims 19 Services Paid
DME-Other DME (DE001N)
Continuous positive airway pressure (cpap) device (HCPCS:E0601)
2 DME suppliers used 14 Medicare Claims 14 Services Paid
DME-Other DME (DE000N)
Iv pole (HCPCS:E0776)
2 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
2 DME suppliers used 19 Medicare Claims 19 Services Paid
DME-Wheelchairs (DD000N)
Standard wheelchair (HCPCS:K0001)
2 DME suppliers used 49 Medicare Claims 49 Services Paid
DME-Wheelchairs (DD021N)
Elevating leg rests, pair (for use with capped rental wheelchair base) (HCPCS:K0195)
1 DME suppliers used 18 Medicare Claims 18 Services Paid
DME-Other DME (DE017N)
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)
4 DME suppliers used 45 Medicare Claims 49 Services Paid
DME-Other DME (DE000N)
Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)
6 DME suppliers used 27 Medicare Claims 27 Services Paid
Unknown
Other-Enteral and Parenteral (OB006N)
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape (HCPCS:B4035)
2 DME suppliers used 13 Medicare Claims 395 Services Paid
Other-Enteral and Parenteral (OB006N)
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit (HCPCS:B4154)
2 DME suppliers used 13 Medicare Claims 5770 Services Paid
Drugs Administered Through DME
DME-Drugs Administered Through DME (DG006N)
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)
4 DME suppliers used 24 Medicare Claims 2670 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Adm sarscov2 30mcg/0.3ml bst
Adm sarscov2 50 mcg/.5 mlbst
Adm sarscov2 50mcg/0.25mlbst
Adm sarscov2 vac ad26 .5ml b
Adm sarscv2 30mcg trs-sucr b
Administration of influenza virus vaccine
Administration of pneumococcal vaccine
Administration of vaccine
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Anticoagulant management of patient taking warfarin
Aspiration and/or injection of fluid from large joint
Automated urinalysis test
Blood count, hemoglobin
Blood test, clotting time
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus
Detection test by immunoassay with direct visual observation for influenza virus
Diabetes outpatient self-management training services, individual, per 30 minutes
Established patient custodial care facility, group care, or assisted living visit, typically 25 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Fee covid-19 vac 13 res
Fee covid-19 vac 14 res
Influenza vaccine split virus, preservative free
Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage
Influenza vaccine, quadrivalent, 0.5 ml dosage
Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage
Initial nursing facility visit per day, typically 45 minutes
Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment
Injection, triamcinolone acetonide, not otherwise specified, 10 mg
Insertion of needle into vein for collection of blood sample
Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 100 mcg/0.5ml dosage; first dose
Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 100 mcg/0.5ml dosage; second dose
Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 30 mcg/0.3ml dosage, diluent reconstituted; second dose
Melanoma (skin cancer) excision
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use
Pneumococcal vaccine, 23-valent
Removal of impacted ear wax
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
Transitional care management services for problem of high complexity
Transitional care management services for problem of moderate complexity
This is an administration of a COVID-19 vaccine, specifically 30 micrograms in a 0.3 milliliter dosage. The vaccine helps your body build protection against the SARS-CoV-2 virus, which causes COVID-19.
This service was performed 142 times for 140 patientsAdm sarscov2 50 mcg/.5 mlbst is a COVID-19 vaccine administration. In this process, a 50 microgram dose of the vaccine is given in a half milliliter volume. This aids your body in building a defense against the virus.
This service was performed 570 times for 570 patientsThis procedure involves administering a dose of a SARS-CoV-2 vaccine. The specific dosage is 50 micrograms in a 0.25 milliliter booster shot. This vaccine helps your body build immunity against the COVID-19 virus. It's a key part of global efforts to control the pandemic.
This service was performed 1,178 times for 1,144 patientsThe Ad26.COV2.S vaccine is a single-dose shot to protect against COVID-19. It's administered as a 0.5ml injection. The vaccine helps your immune system learn how to fight the virus if you're exposed. It's important to receive it to help curb the pandemic.
This service was performed 18 times for 18 patientsThis service involves the administration of a 30mcg dose of the SARS-CoV-2 vaccine, which helps protect against COVID-19. The 'trs-sucr b' indicates it's stabilized with sugars for effectiveness. It's a crucial step in maintaining your health during the pandemic.
This service was performed 132 times for 131 patientsThe 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.
This service was performed 825 times for 817 patientsThe pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
This service was performed 53 times for 52 patientsAdministering a vaccine involves injecting a small, safe piece of a virus or bacteria into your body. This triggers your immune system to recognize and fight off the disease in the future. It's a vital tool in preventing serious illnesses and maintaining public health.
This service was performed 43 times for 38 patientsAn 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.
This service was performed 351 times for 351 patientsAnticoagulant management with warfarin involves monitoring and adjusting your medication to prevent blood clots while minimizing the risk of bleeding. Regular blood tests measure your response to warfarin, helping adjust your dose if necessary. It's crucial to maintain a consistent diet and promptly report any changes in your health.
This service was performed 141 times for 14 patientsThis procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
This service was performed 16 times for 13 patientsAn automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
This service was performed 107 times for 75 patientsA blood count, specifically hemoglobin, is a standard test that measures the amount of hemoglobin in your blood. Hemoglobin is a protein in red blood cells that carries oxygen throughout your body. This test helps assess your overall health and detect a variety of disorders such as anemia or polycythemia.
This service was performed 21 times for 18 patientsA clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.
This service was performed 203 times for 23 patientsChronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
This service was performed 52 times for 12 patientsAn immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.
This service was performed 20 times for 18 patientsThis is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.
This service was performed 40 times for 19 patientsThis service involves personalized training sessions, each lasting 30 minutes, to help manage diabetes. It includes guidance on monitoring blood sugar, healthy eating, physical activity, medication usage, and dealing with daily challenges of living with diabetes.
This service was performed 81 times for 21 patientsThis refers to a routine medical visit for an established patient living in a group care facility, custodial care, or assisted living. The visit typically lasts 25 minutes and includes a check-up and discussion about ongoing healthcare needs.
This service was performed 50 times for 24 patientsThis 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.
This service was performed 145 times for 124 patientsThis 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.
This service was performed 1,081 times for 476 patientsThe "Fee Covid-19 Vac 13 Res" service refers to a charge for the 13th dose of the Covid-19 vaccine, typically for individuals requiring additional doses due to specific health conditions. It's crucial to follow your healthcare provider's advice for your health safety.
This service was performed 214 times for 214 patientsThe "Fee covid-19 vac 14 res" refers to a charge for a specific service related to the COVID-19 vaccine. This could be for administering the vaccine or related care. It's crucial to get vaccinated to protect against the virus. The fee ensures quality service.
This service was performed 1,180 times for 1,180 patientsThe 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.
This service was performed 13 times for 13 patientsThe quadrivalent inactivated influenza vaccine is a shot given to protect against four strains of the flu virus. This 0.5 ml dosage helps your body develop immunity to the virus. It's an important step in preventing flu-related complications.
This service was performed 707 times for 704 patientsThe Influenza vaccine, quadrivalent, 0.5 ml dosage, is a flu shot to protect against four strains of the flu virus. It's given as a small injection, typically in the arm, to help your body build immunity and fight off potential flu infections.
This service was performed 85 times for 83 patientsThe quadrivalent influenza vaccine is a shot to protect you from four different flu viruses. It's preservative-free and given in a 0.5 ml dose. It helps your body build immunity to the flu, reducing your risk of getting sick.
This service was performed 24 times for 23 patientsAn initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
This service was performed 24 times for 23 patientsAn Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.
This service was performed 22 times for 22 patientsTriamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
This service was performed 56 times for 13 patientsThis 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.
This service was performed 742 times for 436 patientsThis is a COVID-19 vaccine injection, given into a muscle. It's the first dose of a two-dose series. The vaccine, made from mRNA technology, targets the virus's spike protein. It's free of preservatives and each dose contains 100 mcg in a 0.5ml solution.
This service was performed 15 times for 15 patientsThis is your second dose of the COVID-19 vaccine, which is given via a shot into your muscle. The vaccine contains a tiny piece of the coronavirus's spike protein, which helps your body recognize and fight the virus. It's preservative-free and contains 100 mcg in a 0.5ml dose.
This service was performed 21 times for 21 patientsThis is your second dose of the COVID-19 vaccine, made to protect against severe acute respiratory syndrome coronavirus 2. It's a 30 mcg/0.3ml dose, preservative-free. The vaccine uses mRNA technology to stimulate your immune response. It's injected into a muscle, usually in the arm.
This service was performed 13 times for 13 patientsMelanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.
This service was performed for 1-10 patientsThis service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.
This service was performed 291 times for 267 patientsThis is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
This service was performed 65 times for 59 patientsThis procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.
This service was performed 19 times for 15 patientsThe Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
This service was performed 25 times for 25 patientsThe 23-valent pneumococcal vaccine is an injection that helps protect against serious infections caused by 23 types of pneumococcal bacteria. It's vital for those at risk, like older adults or people with certain health conditions, to prevent pneumonia, meningitis, and bloodstream infections.
This service was performed 23 times for 22 patientsImpacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
This service was performed 11 times for 11 patientsAn electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
This service was performed 18 times for 17 patientsTransitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.
This service was performed 42 times for 40 patientsTransitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.
This service was performed 18 times for 16 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $20.97 for a new patient copayment and $23.98 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 27909 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $83.9
- Minimum New Patient Price $54.12
- Maximum New Patient Price $165.09
- Average New Patient Copayment $20.97
- Minimum New Patient Copayment $13.53
- Maximum New Patient Copayment $41.27
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $95.94
- Minimum Established Patient Price $17.21
- Maximum Established Patient Price $134.61
- Average Established Patient Copayment $23.98
- Minimum Established Patient Copayment $4.3
- Maximum Established Patient Copayment $33.65
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Overall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 95.11, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 95.11 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 86.31
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: 100
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. -
Cost Score: N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. -
Cost Score: N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Sidney Sutton is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| SENTARA ALBEMARLE MEDICAL CENTER | 1144 N ROAD ST ELIZABETH CITY, NC 27909 | (252) 335-0531 | Acute Care Hospitals | |
| VIDANT CHOWAN HOSPITAL | 211 VIRGINIA RD EDENTON, NC 27932 | (252) 482-8451 | Critical Access Hospitals | |
| SENTARA NORFOLK GENERAL HOSPITAL | 600 GRESHAM DR NORFOLK, VA 23507 | (757) 388-3000 | Acute Care Hospitals | |
| SENTARA LEIGH HOSPITAL | 830 KEMPSVILLE ROAD NORFOLK, VA 23502 | (757) 261-6700 | Acute Care Hospitals |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1811978158, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 62 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
ELIZABETH CITY, NC 27909
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1811978158, enumerated as an "individual" on November 11, 2005.
The provider is located at 1141 N ROAD ST STE G ELIZABETH CITY, NC 27909 and the phone number is (252) 337-9120.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: Blue Cross and Blue Shield of NC,. Please consult your insurance carrier or call the provider to verify.
Sidney Sutton is affiliated with: SENTARA ALBEMARLE MEDICAL CENTER, VIDANT CHOWAN HOSPITAL, SENTARA NORFOLK GENERAL HOSPITAL and SENTARA LEIGH HOSPITAL.