Rachael Sussman, M.D.
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician in Washington, District of Columbia. This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 109 in Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician, and covers specialty classification, practice address, and Medicare Part D prescribing data when reported. According to CMS, every field reflects the provider's official federal registration, see our methodology.
What the federal data shows
Rachael Sussman, M.D. reported a CMS MIPS final score of 80.2/100 - below the 83.1 national average - and filed 1,611 Medicare Part D claims in 2023.
- 80.2/100
- MIPS score · -3 vs avg
- 2K
- Part D claims, 2023
- Likely
- board-certified (heuristic)
Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) - no proprietary rating or editorial opinion is applied.
Rachael Sussman, M.D.'s MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
80 33rd percentile higher than 33% of 477,587 scored providers
Each bar is a band; taller bars hold more scored providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
Source CMS Merit-based Incentive Payment System (MIPS) · 2023
Where Rachael Sussman, M.D. sits
This provider among urogynecology and reconstructive pelvic surgery (urology) physician peers
Across the 56 urogynecology and reconstructive pelvic surgery (urology) physician providers who report both Medicare Part D prescribing and a MIPS quality score, Rachael Sussman, M.D. writes more Part D claims than 73% of them and scores higher on MIPS quality than 29% - placing this provider in the high-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Part D claim volume vs MIPS quality, by specialty percentile
Each dot is one urogynecology and reconstructive pelvic surgery (urology) physician peer from a representative sample of 55; the gold marker is Rachael Sussman, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
Rachael Sussman, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 2 hospital affiliations - signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).
What does the federal data show about Rachael Sussman, M.D.?
Near national averagePrimary specialty
Medicare Part D claims
MIPS final score
Specialty distribution in District of Columbia
How Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician compares to other specialties among District of Columbia providers
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician ranks #330 among District of Columbia's specialties (0% of in-state providers)
Each bar is a specialty's share of the District of Columbia provider total, by primary NUCC taxonomy. The highlighted bar is Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician; the long tail of smaller specialties is omitted for legibility.
Medicare quality performance, MIPS
Rachael Sussman, M.D.'s 2023 MIPS final score plotted against the Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician national average
- MIPS Final Score
- 80.2/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician) - 80.2/100 vs national avg 83.1
Quality benchmarks
- National MIPS avg 2023 reporting year
- Quality dim CMS Quality category
- Cost dim CMS Cost category
- Specialty volume Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician US NPIs
80.2/100 MIPS final score - 2.9 pts below the 83.1 national average
Quality, Cost, Promoting Interoperability, and Improvement Activities composite score for the 2023 performance year. Specialty: Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician. Quality dim: 76.7. Cost dim: 53.5.
The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).
Rachael Sussman, M.D. appears in the CMS NPPES registry as a Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician provider holding M.D. credentials at 3800 RESERVOIR RD NW, Washington, DC, 20007, with a listed phone of (202) 444-4922. NPI 1366718504 was issued on 03/30/2012. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what Sussman most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.
Medicare Part D records for calendar year 2023 show 1,611 prescription claims written by this provider, covering 496 Medicare beneficiaries and totaling roughly $551K in drug spend. These figures capture only Medicare Part D, commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 80.2/100 for the 2023 performance year (Quality 76.7, Cost 53.5), compared with the national average of 83.1.
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician is a narrow specialty nationwide, with 109 enrolled providers across 28 states and an average of 1,103 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist, always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.
Practice Address
Provider Details
| NPI | 1366718504 |
|---|---|
| Specialty | Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician |
| Credentials | M.D. |
| Gender | Female |
| NPI Issued | 03/30/2012 |
Verify this provider's license
PlainDoctor pulls this profile from the CMS NPPES public registry. Confirm Rachael Sussman, M.D.'s current license status, disciplinary history, and board certifications with the D.C. Board of Medicine in District of Columbia before relying on this page for a clinical or care decision.
How we sourced this profile
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
Reporting: Group practice
Hospital and facility affiliations
Facilities where Rachael Sussman, M.D. bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" - a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.
Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).
Industry payments received (2024) - CMS Open Payments transparency data
The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for Rachael Sussman, M.D.. Source: openpaymentsdata.cms.gov.
Total received
$814
Largest payer
Boston Scientific Corporation
Most common payment type
Food and Beverage
Industry payments are not necessarily indicators of bias, they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
Prescribing Breakdown
- 30-Day Fills
- 3,268
- Total Day Supply
- 92,911
- Generic Drug Cost
- $91K
- Antibiotic Claims
- 207
Patient Demographics
- Average Patient Age
- 72.3 years
- Avg HCC Risk Score
- 1.51
- Gender Split
- 71% female / 29% male
- Age Distribution
- <65: 68, 65-74: 215, 75-84: 160, 85+: 53
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Rachael Sussman, M.D. prescribes most
Top Medicare Part D drugs by claim count, 2023
- Estradiol
Estradiol
375 claims
- Myrbetriq
Myrbetriq
310 claims
- Tamsulosin Hcl
Tamsulosin Hcl
173 claims
- Gemtesa 119
Gemtesa
119 claims
- Yuvafem 73
Yuvafem
73 claims
- Nitrofurantoin Mon… 71
Nitrofurantoin Mono-Macro
71 claims
- Sulfamethoxazole-T… 70
Sulfamethoxazole-Trimethoprim
70 claims
- Oxybutynin Chlorid… 55
Oxybutynin Chloride Er
55 claims
| Drug | Claims |
|---|---|
| Estradiol | 375 |
| Myrbetriq Mirabegron | 310 |
| Tamsulosin Hcl | 173 |
| Gemtesa Vibegron | 119 |
| Yuvafem Estradiol | 73 |
| Nitrofurantoin Mono-Macro Nitrofurantoin Monohyd/M-Cryst | 71 |
| Sulfamethoxazole-Trimethoprim Sulfamethoxazole/Trimethoprim | 70 |
| Oxybutynin Chloride Er Oxybutynin Chloride | 55 |
| Solifenacin Succinate | 48 |
| Trospium Chloride Er Trospium Chloride | 26 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician Overview
How Rachael Sussman, M.D. fits within the Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician landscape nationally.
Rachael Sussman, M.D.'s 1,611 claims are above the specialty average of 1,103.
Nearby Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician Providers in District of Columbia
Other clinicians with the same primary specialty enrolled in District of Columbia, drawn from the same CMS NPPES roster as Sussman.
Before you book an appointment
Use this federal record as your verification checklist, not as a recommendation.
- Confirm the NPI record is current in the official CMS registry, providers update their own NPPES details, and moves can lag. Verify this NPI
- Check the active license and any disciplinary history with the District of Columbia medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician peer on Medicare volume and prescribing patterns. Compare providers
Medicare Part D and MIPS figures describe practice patterns in federal programs only, they are not quality ratings, and PlainDoctor does not rate, rank, or recommend providers.
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Frequently Asked Questions
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Data Sources
- Provider Directory
- CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
- Specialty Classification
- NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
- Prescribing Data
- CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
- Quality Performance
- CMS Merit-based Incentive Payment System (MIPS) - 2023 performance year.
- Limitations
- Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.
See our complete data methodology for details on how we collect and process government data.
Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).
Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology