MR. SIDNEY MICHAEL SUTTON SR. MD
NPI 1811978158
Family Medicine in Elizabeth City, NC

Q: What is Sidney Sutton's NPI number?

The NPI number for Sidney Sutton is 1811978158. It was assigned to this individual provider in the NPPES registry on November 11, 2005.

Q: What is Sidney Sutton's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Sidney Sutton was last updated on December 6, 2023. 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.

Active since November 11, 2005PECOS EnrolledAccepts Medicare Assignment

95.11/100

CMS Quality Rating

1141 N ROAD ST STE G, ELIZABETH CITY, NC 27909(252) 337-9120(855) 330-7320 Get Directions Write a Review

NPPES record last updated: December 6, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 6, 2023, Mar 20, 2020, Dec 2, 2019 (3 updates tracked since 2019).

On this page

About Mr. Sidney Michael Sutton Sr. Md NPPES

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

MR. SIDNEY MICHAEL SUTTON SR. MD (NPI 1811978158) is an individual family medicine provider in Elizabeth City, North Carolina, licensed in North Carolina (29045) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Sentara Albemarle Medical Center, and is a graduate of Eastern Virginia Medical School (1982).

NPPES Registry Identity

NPI1811978158

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameMR. SIDNEY MICHAEL SUTTON SR.Credential: MD

Location Address1141 N ROAD ST STE GElizabeth City, NC 27909-3354

Mailing Address1141 N Road St Ste GElizabeth City, NC 27909-3354 · (252) 337-9120 · Fax (855) 330-7320

Phone(252) 337-9120

Fax(855) 330-7320

Sole ProprietorNo

Medical School CMSEastern Virginia Medical SchoolGraduated 1982

Enumeration DateNovember 11, 2005

Last NPPES UpdateDecember 6, 20233 updates tracked since enumeration

NPPES CertifiedDecember 6, 2023

✔ NPI 1811978158 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NC · 29045

Definition

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.

1141 N ROAD ST STE G, Elizabeth City, NC 27909

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Other Identifiers 1

Medicaid5900660NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Cigna Healthcare, UnitedHealthcare.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

Mr. Sidney Michael Sutton Sr. 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 ID9032171996

PECOS Enrollment IDI20090717000599

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 Reassignments

Medicare enrollment records show Sidney Sutton reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Albemarle Physician Services - Sentara, Inc

Same address

Surgery

1177 N ROAD ST
Elizabeth City, NC 27909

Reassigned Medicare billing, North Carolina enrollment
176 clinicians in this Medicare group

NPI 1962719609 (252) 337-9440

Albemarle Regional Health Services

2.6 mi

Public Health, State or Local

711 ROANOKE AVE
Elizabeth City, NC 27909

Reassigned Medicare billing, North Carolina enrollment
27 clinicians in this Medicare group

NPI 1659468130 (252) 338-4404

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 26

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.

888 services438 patients

Insertion of needle into vein for collection of blood sample 36415

This 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.

694 services419 patients

Administration of influenza virus vaccine G0008

The 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.

519 services506 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

443 services443 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An 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.

320 services320 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.

172 services129 patients

Blood test, clotting time 85610

A 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.

147 services21 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic 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.

85 services14 patients

Diabetes outpatient self-management training services, individual, per 30 minutes G0108

This 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.

71 services21 patients

Automated urinalysis test 81003

An 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.

61 services40 patients

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 G0180

This 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.

54 services44 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211

This 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.

53 services50 patients

Transitional care management services for problem of high complexity 99496

Transitional 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.

45 services38 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional 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.

32 services31 patients

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

29 services18 patients

Administration of pneumococcal vaccine G0009

The 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.

29 services29 patients

Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348

An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.

27 services15 patients

Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage 90694

The 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.

26 services26 patients

Administration of vaccine 90471

Administering 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.

25 services25 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This 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.

24 services12 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The 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.

23 services23 patients

Removal of impacted ear wax 69210

Impacted 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.

18 services17 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An 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.

16 services16 patients

Telehealth originating site facility fee Q3014

The Telehealth originating site facility fee is a charge for the location where you receive your telehealth service, such as a clinic or hospital. It covers costs like equipment use, technical support, and other resources needed to provide a secure, effective telehealth visit.

16 services16 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An 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.

13 services13 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An 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.

13 services13 patients

Hospital Affiliations CMS Care Compare 5

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

Sentara Albemarle Medical Center

Acute Care Hospitals · Elizabeth City, NC

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number340109

Location1144 N Road StElizabeth City, NC 27909 · Pasquotank County

Emergency services Birthing friendly

Vidant Chowan Hospital

Critical Access Hospitals · Edenton, NC

2/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number341318

Location211 Virginia RdEdenton, NC 27932 · Chowan County

Emergency services Birthing friendly

The Outer Banks Hospital, Inc

Critical Access Hospitals · Nags Head, NC

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number341324

Location4800 South Croatan HighwayNags Head, NC 27959 · Dare County

Emergency services Birthing friendly

Sentara Norfolk General Hospital

Acute Care Hospitals · Norfolk, VA

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number490007

Location600 Gresham DrNorfolk, VA 23507 · Norfolk City County

Emergency services Birthing friendly

Sentara Leigh Hospital

Acute Care Hospitals · Norfolk, VA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number490046

Location830 Kempsville RoadNorfolk, VA 23502 · Norfolk City County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27909 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

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$95.94 typical visit price

range $17.21 – $134.61

Typical copayment $23.98 (range $4.30 – $33.65)

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.

95.11/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

86.31

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 24

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

12 suppliers113 claims267 services$6.04 avg. paid by Medicare

Normal, low and high calibrator solution / chips A4256

DME-Other DME · category DE000N

2 suppliers16 claims16 services$2.58 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

8 suppliers53 claims67 services$1.10 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

2 suppliers13 claims13 services$113.05 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

2 suppliers13 claims39 services$44.69 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

2 suppliers11 claims63 services$21.94 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

2 suppliers17 claims17 services$68.58 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

2 suppliers17 claims17 services$23.42 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

1 supplier19 claims19 services$21.98 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

2 suppliers26 claims151 services$3.18 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

2 suppliers14 claims14 services$13.25 avg. paid by Medicare

Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035

Other-Enteral and Parenteral · category OB006N

2 suppliers13 claims395 services$7.65 avg. paid by Medicare

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 B4154

Other-Enteral and Parenteral · category OB006N

2 suppliers13 claims5,770 services$0.84 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

2 suppliers49 claims49 services$62.35 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers17 claims17 services$21.27 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

2 suppliers19 claims19 services$6.58 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

2 suppliers14 claims14 services$40.97 avg. paid by Medicare

Iv pole E0776

DME-Other DME · category DE000N

2 suppliers12 claims12 services$13.84 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers19 claims19 services$119.26 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

4 suppliers24 claims2,670 services$0.09 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

2 suppliers49 claims49 services$22.71 avg. paid by Medicare

Elevating leg rests, pair (for use with capped rental wheelchair base) K0195

DME-Wheelchairs · category DD021N

1 supplier18 claims18 services$10.31 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

4 suppliers45 claims49 services$198.44 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

6 suppliers27 claims27 services$25.07 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.

ALBEMARLE PHYSICIAN SERVICES - SENTARA, INC

Family Medicine

1141 N ROAD ST STE G
ELIZABETH CITY, NC 27909

Pasquotank County (252) 337-9120

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 Sidney Sutton's NPI number?

The NPI number for Sidney Sutton is 1811978158. It was assigned to this individual provider in the NPPES registry on November 11, 2005.

Where is Sidney Sutton located?

Sidney Sutton practices at 1141 N Road St Ste G, Elizabeth City, NC 27909. The listed phone number is (252) 337-9120.

What is Sidney Sutton's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sidney Sutton enrolled in Medicare?

Yes. Sidney Sutton 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 Sidney Sutton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sidney Sutton reassigns Medicare benefits to 2 organizations: Albemarle Physician Services - Sentara, Inc (Elizabeth City, NC) and Albemarle Regional Health Services (Elizabeth City, NC). 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 Sidney Sutton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sidney Sutton accept?

Health plans from Blue Cross and Blue Shield of NC, Cigna Healthcare and UnitedHealthcare list Sidney Sutton 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 Sidney Sutton affiliated with any hospitals?

According to CMS data, Sidney Sutton is affiliated with Sentara Albemarle Medical Center, Vidant Chowan Hospital, The Outer Banks Hospital, Inc, Sentara Norfolk General Hospital and Sentara Leigh Hospital.

When was this NPI record last updated?

The NPPES record for Sidney Sutton was last updated on December 6, 2023. 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.