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DR. SUMIR MUKESH BRAHMBHATT MD
NPI 1851749378
Internal Medicine - Rheumatology in Douglasville, GA

Active since May 25, 2016PECOS EnrolledAccepts Medicare Assignment
92.93/100
CMS Quality Rating
6002 PROFESSIONAL PKWY STE 280, DOUGLASVILLE, GA 30134(770) 333-2035(770) 999-2842 Get Directions Write a Review

NPPES record last updated: February 20, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 20, 2023, Sep 2, 2022, Mar 19, 2020 (3 updates tracked since 2020).

About Dr. Sumir Mukesh Brahmbhatt Md NPPES

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

DR. SUMIR MUKESH BRAHMBHATT MD (NPI 1851749378) is an individual rheumatology provider in Douglasville, Georgia, licensed in Georgia (93723) and active in the NPI registry since May 2016. He is enrolled in Medicare PECOS, is affiliated with Wellstar Paulding Medical Center, and maintains a secondary practice location in Albuquerque.

NPPES Registry Identity

NPI1851749378
Entity TypeIndividualMale
Primary Taxonomy207RR0500X
Provider Legal NameDR. SUMIR MUKESH BRAHMBHATTCredential: MD
Location Address6002 PROFESSIONAL PKWY STE 280Douglasville, GA 30134-5627
Mailing Address6002 Professional Pkwy Ste 280Douglasville, GA 30134-5627 · (770) 333-2035 · Fax (770) 999-2842
Phone(770) 333-2035
Fax(770) 999-2842
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateMay 25, 2016
Last NPPES UpdateFebruary 20, 20233 updates tracked since enumeration
NPPES CertifiedFebruary 20, 2023
✔ NPI 1851749378 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
Licenses✔ Licensed in GA · 93723✔ Licensed in AZ · 58787
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
6002 PROFESSIONAL PKWY STE 280, Douglasville, GA 30134
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Secondary Practice Location 1

Location 1Department of Medicine MSC 10-5550, 1 University of New MexicoAlbuquerque, NM 87131-5001 · Phone (505) 272-4761 · Fax (505) 272-3624

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.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

Dr. Sumir Mukesh Brahmbhatt 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 ID6901234020
PECOS Enrollment IDI20221117001288
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 7

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.
193 services105 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
88 services56 patients
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.
37 services37 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.
25 services25 patients
Aspiration and/or injection of fluid from large joint 20610
This 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.
20 services13 patients
Influenza vaccine split virus, preservative free 90662
The 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.
13 services13 patients

Hospital Affiliations CMS Care Compare 3

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

Wellstar Paulding Medical Center

Acute Care Hospitals · Hiram, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110042
Location2518 Jimmy Lee Smith ParkwayHiram, GA 30141 · Paulding County

Wellstar Cobb Medical Center

Acute Care Hospitals · Austell, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110143
Location3950 Austell RdAustell, GA 30106 · Cobb County
Birthing friendly

Wellstar Douglas Medical Center

Acute Care Hospitals · Douglasville, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110184
Location8954 Hospital DriveDouglasville, GA 30134 · Douglas County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30134 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

92.93/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.38
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES

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

ODINAKA JOHN AKUNNE M.D
Urology
6002 PROFESSIONAL PKWY STE 280
DOUGLASVILLE, GA 30134
Douglas County (770) 428-4475

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 Sumir Brahmbhatt's NPI number?

The NPI number for Sumir Brahmbhatt is 1851749378. It was assigned to this individual provider in the NPPES registry on May 25, 2016.

Where is Sumir Brahmbhatt located?

Sumir Brahmbhatt practices at 6002 Professional Pkwy Ste 280, Douglasville, GA 30134. The listed phone number is (770) 333-2035.

What is Sumir Brahmbhatt's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Sumir Brahmbhatt enrolled in Medicare?

Yes. Sumir Brahmbhatt 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 Sumir Brahmbhatt accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Sumir Brahmbhatt 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 Sumir Brahmbhatt affiliated with any hospitals?

According to CMS data, Sumir Brahmbhatt is affiliated with Wellstar Paulding Medical Center, Wellstar Cobb Medical Center and Wellstar Douglas Medical Center.

When was this NPI record last updated?

The NPPES record for Sumir Brahmbhatt was last updated on February 20, 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.