Active NPI 1205088507 Individual Practitioner Male Practitioner

Dr. Sumit Sitole , MD

Ophthalmology • Denver, CO

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Sumit Sitole, MD is a certified Ophthalmology practicing in Denver, CO. With approximately 22 years of clinical experience since graduating from Tufts University School Of Medicine in 2004, Dr. Sitole delivers high-quality medical care to the local community at 55 MADISON ST.

Dr. Sitole is affiliated with Denver Oculoplastics and accepts Medicare assignment.

Frequently performed procedures and clinical services include photography of content of eyes, new patient outpatient office visit, exam of visual field with extended testing. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

55 Madison St
355

Denver, CO 802065419

Telephone 3033772020

Fax 3033880606

Associated Practice Facility / Clinic

🏢 Madison Street Surgery Center, Llc Facility NPI 1326132291

Medicare Profile & Education

Medical School

Tufts University School Of Medicine

Graduation Year

2004

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Ophthalmology in Denver, CO

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

22 Yrs -3.9 yrs vs City Avg

City Avg: 25.9 Yrs

State Avg: 25.9 Yrs

Regional Practice Density

85 Specialists

Practicing in Denver, CO (361 Statewide)

Telehealth Adoption Rate

1.2% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

44.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Sitole (22 Years) 22 Yrs

Denver Specialty Average (25.9 Years) 25.9 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92285 Photography of content of eyes	154	147	$45.92	$21.26
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	147	147	$221.34	$111.93
92083 Exam of visual field with extended testing	97	94	$131.34	$64.61
99213 Established patient office or other outpatient visit, typically 15 minutes	65	54	$154.28	$91.45
67917 Extensive repair of turning-outward eyelid defect	40	36	$1286.26	$656.78
67917 Extensive repair of turning-outward eyelid defect	24	22	$1286.26	$584.88
68840 Probing of nasal-tear duct	21	20	$271.94	$180.02
67904 Repair of tendon of upper eyelid	20	20	$1535.02	$887.87
67904 Repair of tendon of upper eyelid	11	11	$1535.02	$980.98

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	177	177	$221.34	$113.01
92285 Photography of content of eyes	169	159	$45.92	$21.27
92083 Exam of visual field with extended testing	108	106	$131.34	$64.32
99213 Established patient office or other outpatient visit, typically 15 minutes	76	62	$154.28	$90.36
67917 Extensive repair of turning-outward eyelid defect	57	47	$1286.26	$606.98
68840 Probing of nasal-tear duct	35	32	$271.94	$184.72
67904 Repair of tendon of upper eyelid	29	29	$1535.02	$882.61
67917 Extensive repair of turning-outward eyelid defect	29	25	$1286.26	$468.04
67904 Repair of tendon of upper eyelid	23	21	$1535.02	$988.73
67875 Temporary closure of eyelids by suture	19	14	$369.32	$93.89
67840 Removal of eyelid growth	16	16	$583.32	$280.87
67900 Repair of brow paralysis	14	14	$1342.68	$555.18
15823 Removal of excessive skin and fat of upper eyelid	14	14	$1278.86	$689.86

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	192	192	$221.34	$113.59
92285 Photography of content of eyes	164	158	$45.92	$21.42
92083 Exam of visual field with extended testing	100	97	$131.34	$65.06
99213 Established patient office or other outpatient visit, typically 15 minutes	90	75	$154.28	$92.48
67917 Extensive repair of turning-outward eyelid defect	44	41	$1286.26	$614.74
68840 Probing of nasal-tear duct	38	33	$271.94	$190.80
67917 Extensive repair of turning-outward eyelid defect	35	32	$1286.26	$534.46
67904 Repair of tendon of upper eyelid	32	32	$1535.02	$891.08
67904 Repair of tendon of upper eyelid	19	19	$1535.02	$1033.02
67875 Temporary closure of eyelids by suture	14	11	$369.32	$123.42
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	13	11	$1601.30	$464.87
67840 Removal of eyelid growth	12	12	$583.32	$296.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	189	189	$221.34	$116.08
92285 Photography of content of eyes	150	141	$45.92	$21.53
92083 Exam of visual field with extended testing	102	98	$131.34	$66.77
99213 Established patient office or other outpatient visit, typically 15 minutes	78	62	$154.28	$94.59
68840 Probing of nasal-tear duct	38	33	$271.94	$180.01
67917 Extensive repair of turning-outward eyelid defect	36	33	$1286.26	$542.16
67904 Repair of tendon of upper eyelid	33	33	$1535.02	$893.89
67840 Removal of eyelid growth	28	27	$583.32	$307.26
67917 Extensive repair of turning-outward eyelid defect	21	18	$1286.26	$597.14
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	17	15	$1601.30	$669.26
15823 Removal of excessive skin and fat of upper eyelid	14	13	$1278.86	$737.25
67800 Removal of eyelid growth	13	13	$267.02	$124.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	112	112	$222.12	$111.62
92285 Photography of content of eyes	88	82	$51.21	$20.97
92083 Exam of visual field with extended testing	49	48	$128.12	$66.20
99213 Established patient office or other outpatient visit, typically 15 minutes	43	31	$153.58	$77.19
67917 Extensive repair of turning-outward eyelid defect	35	31	$1269.01	$497.45
68840 Probing of nasal-tear duct	23	20	$268.73	$191.26
67904 Repair of tendon of upper eyelid	18	18	$1564.46	$898.60
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	11	11	$95.52	$45.37

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	91	77	$113.96	$75.60
92285 Photography of content of eyes	84	77	$82.98	$21.13
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	84	84	$175.00	$110.38
92081 Exam of visual field with limited testing	36	35	$80.00	$31.25
68840 Probing of nasal-tear duct	33	31	$562.12	$170.20
67904 Repair of tendon of upper eyelid	24	23	$3795.83	$793.20
15823 Removal of excessive skin and fat of upper eyelid	20	19	$3493.75	$750.18
67840 Removal of eyelid growth	17	17	$554.39	$269.96
67917 Extensive repair of turning-outward eyelid defect	15	14	$2180.00	$564.39
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	14	14	$71.71	$46.07
92082 Exam of visual field with intermediate testing	13	13	$104.00	$48.98
67900 Repair of brow paralysis	12	11	$2375.00	$370.23
92083 Exam of visual field with extended testing	11	11	$117.00	$65.63

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	149	131	$110.00	$73.60
92285 Photography of content of eyes	118	114	$85.00	$18.36
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	100	100	$165.00	$109.44
67904 Repair of tendon of upper eyelid	56	55	$4642.86	$841.88
92082 Exam of visual field with intermediate testing	53	52	$104.00	$49.26
67917 Extensive repair of turning-outward eyelid defect	52	46	$2188.38	$501.69
92081 Exam of visual field with limited testing	45	45	$80.00	$35.23
68840 Probing of nasal-tear duct	41	41	$580.49	$177.86
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	28	26	$67.00	$44.55
15823 Removal of excessive skin and fat of upper eyelid	21	21	$3758.33	$722.16
67900 Repair of brow paralysis	18	18	$2833.33	$389.82
67840 Removal of eyelid growth	16	16	$554.00	$274.14
67875 Temporary closure of eyelids by suture	14	13	$851.21	$55.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	168	145	$110.00	$73.20
92285 Photography of content of eyes	156	146	$85.00	$18.59
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	96	96	$165.00	$108.25
92081 Exam of visual field with limited testing	65	61	$80.00	$33.92
68840 Probing of nasal-tear duct	64	60	$508.59	$180.29
67917 Extensive repair of turning-outward eyelid defect	51	47	$2154.35	$515.94
92082 Exam of visual field with intermediate testing	45	45	$104.00	$49.02
67904 Repair of tendon of upper eyelid	40	38	$4375.00	$808.97
15823 Removal of excessive skin and fat of upper eyelid	23	22	$3515.22	$706.98
67875 Temporary closure of eyelids by suture	20	16	$736.05	$49.80
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	16	16	$67.00	$44.00

Medical Specialties & State Licenses

Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

State License MD D67988

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

84034785 (CO)

Commercial Insurance / Payer ID Medical License

49102 (CO)

Hospital & Practice Group Affiliations

Denver Oculoplastics

5150 E Yale Cir, Denver, CO 802226936

Phone: 7206998687

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners

Kiok Cho , ANP-BC

Nurse Practitioner - Adult Health

NPI 1003101627

ANPBC

Dr. Betty Zhang , OD

Optometrist

NPI 1053833681

Doctor of Optometry

Dr. Mariana Harasawa , MD

Ophthalmology - Retina Specialist

NPI 1154785863

Doctor of Medicine (M.D.)

Dr. Jason Wang , MD

Ophthalmology

NPI 1275514937

Doctor of Medicine (M.D.)

Dr. James Dowgin , OD

Optometrist

NPI 1386271443

Doctor of Optometry

Dr. George Pardos , MD

Specialist

NPI 1528059789

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active September 10, 2012

NPI status registered as active in NPPES database

📍

Updated Practice Location September 10, 2012

Registered at 55 MADISON ST, 355, DENVER, CO 802065419 (Tel: 3033772020)

📍

Updated Business Mailing Address September 10, 2012

Registered at 5245 SKYTRAIL DR, BOW MAR, CO 801231566 (Tel: 6173200321)

👤

Provider Name / Credentials Updated September 10, 2012

Recorded as SUMIT SITOLE, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 10, 2012

Ophthalmology (License #D67988 in MD)

🟢

Initial NPI Registration & Enumeration October 17, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1205088507

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 17, 2008

Last Update: September 10, 2012

Sole Proprietor: No

Update or Correct Profile

Mailing Address

5245 Skytrail Dr

Bow Mar, CO 801231566

Phone: 6173200321

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.