DR. SUMIT NARAYANPRASAD FOGLA (M.D) – Family Medicine Physician, NPI 1467652347
Family Medicine Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. SUMIT NARAYANPRASAD FOGLA (M.D)
21400 E ELEVEN MILE ROAD
ST. CLAIR SHORES, MI 48081
Phone: (586) 498-4400
Fax: (586) 498-4440
Type: Mailing
1120 15TH ST
OR 6000
AUGUSTA, GA 309120004
Phone: (706) 721-3813
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $113.
Total Amount is formed as General ($113) + Research ($0) + Ownership ($0) = $113.
Last reported payment date: 2024-07-26 • Largest payer in this snapshot: Lundbeck LLC ($32).
Total Amount
$113
General + Research + Ownership
Payments
5
Total payment records
General Amount
$113
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lundbeck LLC | $32 |
| PFIZER INC. | $27 |
| Novo Nordisk Inc | $24 |
| Lilly USA, LLC | $15 |
| Exact Sciences Corporation | $14 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-12-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20080731000794 | I | Family Practice | MI | TBD |
| I20211207000900 | I | Family Practice | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 653 | 198 | $0 |
| 99439 | Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month | 268 | 124 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 176 | 111 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 25 | 23 | $0 |
Insurance plans in this area (ZIP 48081)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Hematology/Oncology, Internal Medicine | MI | |
| P S Y C H I A T R Y | MI | |
| - | MI | |
| Internal Medicine, Cardiovascular Disease (Cardiology) | MI | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology) | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI |
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