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JOHN MICHAEL SUTTER M.D.
NPI 1861711509
Family Medicine in Marysville, OH

Active since May 20, 2010PECOS EnrolledAccepts Medicare Assignment
87.77/100
CMS Quality Rating
140 COLEMANS XING STE 110, MARYSVILLE, OH 43040(937) 578-7950 Get Directions Write a Review

NPPES record last updated: November 7, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 7, 2022, Dec 1, 2015 (2 updates tracked since 2015).

About John Michael Sutter M.d. NPPES

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

JOHN MICHAEL SUTTER M.D. (NPI 1861711509) is an individual family medicine provider in Marysville, Ohio, licensed in Ohio (35.120899) and active in the NPI registry since May 2010. He is enrolled in Medicare PECOS, is affiliated with Memorial Hospital, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1861711509
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJOHN MICHAEL SUTTERCredential: M.D.
Location Address140 COLEMANS XING STE 110Marysville, OH 43040-7080
Mailing Address140 Colemans Xing Ste 110Marysville, OH 43040-7080
Phone(937) 578-7950
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateMay 20, 2010
Last NPPES UpdateNovember 7, 20222 updates tracked since enumeration
NPPES CertifiedNovember 7, 2022
✔ NPI 1861711509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OH · 35.120899
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.
140 COLEMANS XING STE 110, Marysville, OH 43040
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, MedMutual 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

John Michael Sutter 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 ID6103065123
PECOS Enrollment IDI20130622000039
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

2

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

Union County Physician Corporation
1.1 mi
Occupational Medicine
500 LONDON AVE, DEPARTMENT OF OCCUPATIONAL HEALTH
Marysville, OH 43040
  • Reassigned Medicare billing, Ohio enrollment
  • 144 clinicians in this Medicare group
NPI 1497300172 (937) 578-2417
Ohiohealth Corporation
22 mi
Cardiovascular Disease
3705 OLENTANGY RIVER RD, SUITE 100
Columbus, OH 43214
  • Reassigned Medicare billing, Ohio enrollment
  • 3,314 clinicians in this Medicare group
NPI 1194979526 (614) 262-6772

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.

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.
141 services69 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.
57 services41 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.
40 services33 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.
12 services12 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.
12 services12 patients

Hospital Affiliations CMS Care Compare

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

Memorial Hospital

Acute Care Hospitals · Marysville, OH
5/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number360092
Location500 London AvenueMarysville, OH 43040 · Union County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43040 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

87.77/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality88.17
Promoting Interoperability100
Improvement Activities40
Cost71.09

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 John Sutter's NPI number?

The NPI number for John Sutter is 1861711509. It was assigned to this individual provider in the NPPES registry on May 20, 2010.

Where is John Sutter located?

John Sutter practices at 140 Colemans Xing Ste 110, Marysville, OH 43040. The listed phone number is (937) 578-7950.

What is John Sutter's specialty?

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

Is John Sutter enrolled in Medicare?

Yes. John Sutter 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 John Sutter's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Sutter reassigns Medicare benefits to 2 organizations: Union County Physician Corporation (Marysville, OH) and Ohiohealth Corporation (Columbus, OH). 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 John Sutter's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does John Sutter accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource, MedMutual, Molina Healthcare and Oscar Health Insurance list John Sutter 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 John Sutter affiliated with any hospitals?

According to CMS data, John Sutter is affiliated with Memorial Hospital.

When was this NPI record last updated?

The NPPES record for John Sutter was last updated on November 7, 2022. 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.