DR. SAMATHA KRISHNA KADIYALA M.D. NPI 1003002627

Obstetrics & Gynecology in Lake Jackson, TX

NPI 1003002627 Individual Female Years of Experience 22 Obstetrics & Gynecology PECOS Enrolled Accepts Medicare Approved Payment

NPI Profile for DR. SAMATHA KRISHNA KADIYALA M.D.

Samatha Kadiyala is a women's health care provider established in Lake Jackson, Texas and her medical specialization is obstetrics & gynecology with more than 22 years of experience. The NPI number of Samatha Kadiyala is 1003002627 and was assigned on September 2007. The practitioner's primary taxonomy code is 207V00000X with license number N4502 (TX). The provider is registered as an individual and her NPI record was last updated 6 years ago.

Women's health care providers like Dr. Samatha Krishna Kadiyala M.d. treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.

Samatha Kadiyala is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Samatha Kadiyala is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data she has hospital affiliations with Chi St. Lukes' Brazosport Hospital, Sweeny Community Hospital and University Of Texas Medical Branch Galveston.

The typical physician office visit costs for Medicare beneficiaries in this area are: $34.17 for a new patient copayment and $18.67 for an established patient copayment.

NPI

1003002627

Provider NameDR. SAMATHA KRISHNA KADIYALA M.D.
Provider Location Address506 THIS WAY ST LAKE JACKSON, TX 77566
Provider Mailing Address215 OAK DRIVE SOUTH SUITE B LAKE JACKSON, TX 77566
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2001
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date09-18-2007
Last Update Date06-06-2016


Primary Taxonomy

Taxonomy Code207V00000X
ClassificationObstetrics & Gynecology
TypeAllopathic & Osteopathic Physicians
License No.N4502
License StateTX
Taxonomy DescriptionAn obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Business Address

DR. SAMATHA KRISHNA KADIYALA M.D.
506 THIS WAY ST
LAKE JACKSON, TX
ZIP 77566
Phone: (979) 266-9544
Fax: (979) 529-9737

Get Directions


Mailing Address

DR. SAMATHA KRISHNA KADIYALA M.D.
215 OAK DRIVE SOUTH
SUITE B
LAKE JACKSON, TX
ZIP 77566
Phone: (979) 266-9544
Fax: (979) 529-9737



PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID6800954280
PECOS Enrollment IDI20091027000539
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 77566 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$59.58 $180.4 $136.68
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.89 $45.1 $34.17
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99213
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$18.76 $147.85 $74.68
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.69 $36.96 $18.67

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 247Urinalysis, manual test (HCPCS:81002)
  • 60Cervical or vaginal cancer screening; pelvic and clinical breast examination (HCPCS:G0101)
  • 39Stool analysis for blood to screen for colon tumors (HCPCS:82270)
  • 37Ultrasound measurement of bladder capacity after voiding (HCPCS:51798)
  • 34Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous (HCPCS:G0328)
  • 31Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory (HCPCS:Q0091)
  • 11Ultrasound pelvis through vagina (HCPCS:76830)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Samatha Kadiyala is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
CHI ST. LUKES' BRAZOSPORT HOSPITAL100 MEDICAL DRIVE
LAKE JACKSON, TX 77566
(979) 297-4411Acute Care Hospitals450072
SWEENY COMMUNITY HOSPITAL305 NORTH MCKINNEY
SWEENY, TX 77480
(979) 548-3311Critical Access Hospitals451311
UNIVERSITY OF TEXAS MEDICAL BRANCH GALVESTON301 UNIVERSITY BOULEVARD
GALVESTON, TX 77555
(409) 772-1011Acute Care Hospitals450018

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
8L20445MEDICARE UPIN (02)TX
206442001MEDICAID (05)TX

NPI Validation Check Digit Calculation


The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1003002627
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
200300464
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 0 + 4 + 6 + 4 + 24 = 43
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 43 = 77

The NPI number 1003002627 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1548555329FOOT DOCTORS OF TEXAS LLC
Organization
Podiatrist506 THIS WAY ST
LAKE JACKSON, TX 77566
(979) 297-7798
1407163116BRAZOSPORT WOMENS HEALTH PA
Organization
Obstetrics & Gynecology (Gynecology)506 THIS WAY ST
LAKE JACKSON, TX 77566
(979) 266-9544

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Dr. Samatha Krishna Kadiyala M.d. is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.