Active NPI 1841236270 Individual Practitioner Female Practitioner

Dr. Sumaira Ali , MD

Internal Medicine • Westerly, RI

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Sumaira Ali, MD is a certified Internal Medicine practicing in Westerly, RI. With approximately 30 years of clinical experience since completing medical education in 1996, Dr. Ali delivers high-quality medical care to the local community at 45 WELLS ST STE 201.

Dr. Ali is affiliated with Northeast Medical Group Inc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, administration of influenza virus vaccine. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

45 Wells St Ste 201

Westerly, RI 028912927

Telephone 4016377202

Fax 8608652393

Associated Practice Facility / Clinic

🏢 Gastroenterology Specialists, Inc Facility NPI 1780782706

Medicare Profile & Education

Medical School

Other

Graduation Year

1996

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Westerly, RI

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

30 Yrs -4.1 yrs vs City Avg

City Avg: 34.1 Yrs

State Avg: 27.9 Yrs

Regional Practice Density

18 Specialists

Practicing in Westerly, RI (1079 Statewide)

Telehealth Adoption Rate

11.1% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

60.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Ali (30 Years) 30 Yrs

Westerly Specialty Average (34.1 Years) 34.1 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
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	456	256	$268.95	$128.91
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	219	219	$398.60	$130.52
99213 Established patient office or other outpatient visit, typically 15 minutes	102	79	$182.00	$91.68
G0008 Administration of influenza virus vaccine	35	35	$51.00	$32.68
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	24	24	$581.33	$165.42
90653 Vaccine for influenza for injection into muscle	20	20	$75.00	$71.66
93000 Routine ekg using at least 12 leads including interpretation and report	15	14	$86.27	$14.42
G0009 Administration of pneumococcal vaccine	14	14	$51.00	$32.68
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	14	13	$32.00	$16.36

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	435	253	$269.32	$130.23
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	196	196	$395.32	$131.28
99213 Established patient office or other outpatient visit, typically 15 minutes	130	110	$183.85	$91.51
G0009 Administration of pneumococcal vaccine	45	45	$51.00	$31.37
G0008 Administration of influenza virus vaccine	30	29	$51.00	$31.37
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	29	29	$561.38	$167.65
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	26	26	$385.00	$169.97
83036 Hemoglobin A1C level	19	18	$23.21	$9.52
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	18	18	$395.00	$282.08
90662 Influenza vaccine split virus, preservative free	15	14	$131.00	$71.70
93000 Routine ekg using at least 12 leads including interpretation and report	13	13	$81.38	$14.80

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	466	249	$268.00	$132.54
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	136	136	$400.00	$134.65
99213 Established patient office or other outpatient visit, typically 15 minutes	126	102	$182.00	$94.21
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	52	52	$600.00	$172.23
G0008 Administration of influenza virus vaccine	47	47	$51.00	$30.62
G0009 Administration of pneumococcal vaccine	46	46	$51.00	$30.68
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	26	26	$395.00	$278.49
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	24	24	$171.73	$130.40
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	24	24	$413.38	$173.64
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	19	14	$121.10	$92.48
90662 Influenza vaccine split virus, preservative free	15	15	$131.00	$68.54
83036 Hemoglobin A1C level	14	11	$23.00	$9.58
99496 Transitional care management services for problem of high complexity	13	12	$734.00	$288.07
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$272.00	$116.72

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	171	105	$268.00	$133.95
99213 Established patient office or other outpatient visit, typically 15 minutes	140	93	$182.00	$94.94
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	53	53	$362.53	$137.94
G0008 Administration of influenza virus vaccine	48	48	$51.00	$17.73
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	44	44	$415.00	$175.10
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	32	32	$172.69	$133.10
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	28	28	$560.03	$174.55
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	23	16	$121.88	$93.75
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	22	22	$272.00	$117.35
90662 Influenza vaccine split virus, preservative free	18	18	$74.00	$65.26
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	18	18	$173.03	$133.10
99306 Initial nursing facility visit, typically 45 minutes per day	17	16	$222.21	$171.08
G0009 Administration of pneumococcal vaccine	16	16	$51.00	$17.72
99495 Transitional care management services for problem of at least moderate complexity	13	12	$541.00	$214.93

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	103	61	$182.00	$79.39
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	86	55	$268.00	$115.44
G0008 Administration of influenza virus vaccine	43	43	$51.00	$17.61
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	38	33	$176.52	$134.69
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	33	28	$124.42	$95.63
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	27	27	$415.00	$173.99
90662 Influenza vaccine split virus, preservative free	22	22	$63.91	$52.67
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	21	21	$512.51	$180.73
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	20	20	$375.79	$122.98
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	17	16	$176.52	$134.75
99306 Initial nursing facility visit, typically 45 minutes per day	17	16	$227.69	$174.92
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	15	15	$272.00	$114.07
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	13	11	$124.42	$95.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	137	119	$177.63	$135.94
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	82	67	$124.99	$95.65
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	52	50	$177.63	$135.93
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	39	30	$124.99	$95.68
99213 Established patient office or other outpatient visit, typically 15 minutes	29	18	$182.00	$77.76
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	28	27	$93.99	$71.93
99316 Nursing facility discharge management, more than 30 minutes	24	23	$144.24	$110.43
99306 Initial nursing facility visit, typically 45 minutes per day	17	17	$227.46	$174.08
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	11	11	$301.45	$179.68
99315 Nursing facility discharge day management, 30 minutes or less	11	11	$100.24	$76.75
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$415.00	$172.00

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	198	162	$178.24	$134.51
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	163	105	$125.16	$94.02
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	101	67	$125.20	$94.60
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	64	56	$178.28	$134.37
99315 Nursing facility discharge day management, 30 minutes or less	52	45	$99.76	$75.38
99316 Nursing facility discharge management, more than 30 minutes	34	34	$145.03	$109.08
99497 Advance care planning, first 30 minutes	31	29	$112.24	$81.62
99306 Initial nursing facility visit, typically 45 minutes per day	25	22	$228.05	$170.96
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	18	18	$160.80	$119.47
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	17	17	$236.29	$177.51
99315 Nursing facility discharge day management, 30 minutes or less	17	17	$99.70	$75.43
99497 Advance care planning, first 30 minutes	14	13	$115.74	$87.00

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	125	108	$175.83	$130.96
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	124	81	$123.85	$92.04
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	116	71	$123.69	$91.98
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	56	44	$175.93	$130.96
99316 Nursing facility discharge management, more than 30 minutes	30	28	$142.80	$106.41
99306 Initial nursing facility visit, typically 45 minutes per day	21	21	$225.71	$167.64
99315 Nursing facility discharge day management, 30 minutes or less	20	20	$98.80	$73.76
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	18	18	$233.00	$172.34
99316 Nursing facility discharge management, more than 30 minutes	17	15	$142.88	$106.36
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	14	13	$94.00	$69.47

Medical Specialties & State Licenses

CMS Verified: 2020-09-18

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License RI 10826

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

7009537 (RI)

Hospital & Practice Group Affiliations

Northeast Medical Group Inc

45 Wells St, Westerly, RI 028912927

Phone: 4015967736

Secondary Practice Locations

735 Putnam Pike

Greenville, RI 028281435

Phone: 4019491200

Practice Associates & Co-Workers

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

3 Associated Practitioners

Dr. Marianne Longacre , DO

Family Medicine

NPI 1396776266

Doctor of Osteopathic Medicine (D.O.)

Dandie Gallaher , LICSW

Social Worker - Clinical

NPI 1477972396

Licensed Independent Clinical Social Worker

Stephanie Rizzuto , FNP-C

Nurse Practitioner - Family

NPI 1588316921

Family Nurse Practitioner (Certified)

Career & Practice History Timeline

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

8 Historical Events

📍

Updated Practice Location September 18, 2020

Registered at 45 WELLS ST STE 201, WESTERLY, RI 028912927 (Tel: 4016377202)

📍

Updated Business Mailing Address September 18, 2020

Registered at 45 WELLS ST, WESTERLY, RI 028912961 (Tel: 4016377202)

✅

NPI Profile Active May 02, 2014

NPI status registered as active in NPPES database

📍

Updated Practice Location May 02, 2014

Registered at 735 PUTNAM PIKE, GREENVILLE, RI 028281435 (Tel: 4019491200)

📍

Updated Business Mailing Address May 02, 2014

Registered at 735 PUTNAM PIKE, GREENVILLE, RI 028281435 (Tel: 4019491200)

👤

Provider Name / Credentials Updated May 02, 2014

Recorded as SUMAIRA ALI, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 02, 2014

Internal Medicine (License #10826 in RI)

🟢

Initial NPI Registration & Enumeration June 22, 2006

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: 1841236270

Entity Type:

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

Enumeration Date: June 22, 2006

Last Update: September 18, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

45 Wells St

Westerly, RI 028912961

Phone: 4016377202

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.