DR. SAMATHA KRISHNA KADIYALA M.D. NPI 1003002627
Obstetrics & Gynecology in Lake Jackson, TX

About 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 this provider 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 7 years ago.

NPI
1003002627
Provider NameDR. SAMATHA KRISHNA KADIYALA M.D.
Location Address506 THIS WAY ST LAKE JACKSON, TX 77566
Location Phone(979) 266-9544
Mailing Address215 OAK DRIVE SOUTH SUITE B LAKE JACKSON, TX 77566
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2001
Is Sole Proprietor?No
Enumeration Date09-18-2007
Last Update Date06-06-2016

Women's health care providers like Samatha Kadiyala 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 .

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 84, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance. The provider also has detailed performance information the following quality measures: breast cancer screening, closing the referral loop: receipt of specialist report, colorectal cancer screening, documentation of current medications in the medical record, engage patients and families to guide improvement in the system of care, engagement of patients through implementation of improvements in patient portal, engagement of patients, family, and caregivers in developing a plan of care, e-prescribing, evidenced-based techniques to promote self-management into usual care, implementation of condition-specific chronic disease self-management support programs, pneumococcal vaccination status for older adults, preventive care and screening: body mass index (bmi) screening and follow-up plan, preventive care and screening: influenza immunization, preventive care and screening: tobacco use: screening and cessation intervention, provide patients electronic access to their health information, public health registry reporting, query of the prescription drug monitoring program (pdmp), security risk analysis, support electronic referral loops by receiving and incorporating health information and support electronic referral loops by sending health information.

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.



Primary Taxonomy

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.

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.

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:

  • Medicaid
  • Medicare

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Business Address

506 THIS WAY ST
LAKE JACKSON, TX
ZIP 77566
Phone: (979) 266-9544
Fax: (979) 529-9737

Get Directions


Mailing Address

215 OAK DRIVE SOUTH
SUITE B
LAKE JACKSON, TX
ZIP 77566
Phone: (979) 266-9544
Fax: (979) 529-9737


Location Map

PECOS Enrollment and Medicare Participation Status

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.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

MIPS Measure Score Weight Score
Quality 40% 77.9
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability (PI) 25% 87
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities 15% 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost 20% N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
MIPS Final Score - 84
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

MIPS Quality Measures

The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.

Quality Measure Performance Number of Patients
Breast Cancer Screening 55% 493
Percentage of women 50 - 74 years of age who had a mammogram to screen for breast cancer in the 27 months prior to the end of the measurement period.
Cervical Cancer Screening 67% 840
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria:* Women age 21-64 who had cervical cytology performed every 3 years* Women age 30-64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years.
Chlamydia Screening for Women 0% 122
Percentage of women 16-24 years of age who were identified as sexually active and who had at least one test for chlamydia during the measurement period.
Closing the Referral Loop: Receipt of Specialist Report 0% 59
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred.
Colorectal Cancer Screening 0% 526
Percentage of patients 50-75 years of age who had appropriate screening for colorectal cancer.
Documentation of Current Medications in the Medical Record 85% 2279
Percentage of visits for patients aged 18 years and older for which the MIPS eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration.
Engage Patients and Families to Guide Improvement in the System of CareYesN/A
Engage patients and families to guide improvement in the system of care by leveraging digital tools for ongoing guidance and assessments outside the encounter, including the collection and use of patient data for return-to-work and patient quality of life improvement. Platforms and devices that collect patient-generated health data (PGHD) must do so with an active feedback loop, either providing PGHD in real or near-real time to the care team, or generating clinically endorsed real or near-real time automated feedback to the patient, including patient reported outcomes (PROs). Examples include patient engagement and outcomes tracking platforms, cellular or web-enabled bi-directional systems, and other devices that transmit clinically valid objective and subjective data back to care teams. Because many consumer-grade devices capture PGHD (for example, wellness devices), platforms or devices eligible for this improvement activity must be, at a minimum, endorsed and offered clinically by care teams to patients to automatically send ongoing guidance (one way). Platforms and devices that additionally collect PGHD must do so with an active feedback loop, either providing PGHD in real or near-real time to the care team, or generating clinically endorsed real or near-real time automated feedback to the patient (e.g. automated patient-facing instructions based on glucometer readings). Therefore, unlike passive platforms or devices that may collect but do not transmit PGHD in real or near-real time to clinical care teams, active devices and platforms can inform the patient or the clinical care team in a timely manner of important parameters regarding a patient's status, adherence, comprehension, and indicators of clinical concern.
Engagement of patients through implementation of improvements in patient portalYesN/A
Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence.
Engagement of Patients, Family, and Caregivers in Developing a Plan of CareYesN/A
Engage patients, family, and caregivers in developing a plan of care and prioritizing their goals for action, documented in the electronic health record (EHR) technology.
e-Prescribing 99% 692
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using CEHRT.
Evidenced-based techniques to promote self-management into usual careYesN/A
Incorporate evidence-based techniques to promote self-management into usual care, using techniques such as goal setting with structured follow-up, Teach Back, action planning or motivational interviewing.
Implementation of condition-specific chronic disease self-management support programsYesN/A
Provide condition-specific chronic disease self-management support programs or coaching or link patients to those programs in the community.
Pneumococcal Vaccination Status for Older Adults 0% 309
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 23% 1317
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter.
Preventive Care and Screening: Influenza Immunization 0% 666
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization.
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 11% 81
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco usera. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months.b. Percentage of patients aged 18 years and older who were identified as a tobacco user who received tobacco cessation intervention.c. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user.
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 94% 881
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco usera. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months.b. Percentage of patients aged 18 years and older who were identified as a tobacco user who received tobacco cessation intervention.c. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user.
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 86% 881
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco usera. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months.b. Percentage of patients aged 18 years and older who were identified as a tobacco user who received tobacco cessation intervention.c. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user.
Provide Patients Electronic Access to Their Health Information 84% 421
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient-authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified electronic health record technology (CEHRT).
Public Health Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement with a public health agency to submit data to public health registries.
Query of the Prescription Drug Monitoring Program (PDMP)YesN/A
For at least one Schedule II opioid electronically prescribed using CEHRT during the performance period, the MIPS eligible clinician uses data from CEHRT to conduct a query of a Prescription Drug Monitoring Program (PDMP) for prescription drug history, except where prohibited and in accordance with applicable law.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified electronic health record technology (CEHRT) in accordance with requirements in 45 CFR 164.312(a)(2)(iv) and 164.306(d)(3), implement security updates as necessary, and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Support Electronic Referral Loops By Receiving and Incorporating Health Information 43% 58
For at least one electronic summary of care record received for patient encounters during the performance period for which a MIPS eligible clinician was the receiving party of a transition of care or referral, or for patient encounters during the performance period in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician conducts clinical information reconciliation for medication, medication allergy, and current problem list.
Support Electronic Referral Loops By Sending Health Information 100% 36
For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider - (1) creates a summary of care record using certified electronic health record technology (CEHRT); and (2) electronically exchanges the summary of care record.
Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents 97% 39
Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.- Percentage of patients with height, weight, and body mass index (BMI) percentile documentation.- Percentage of patients with counseling for nutrition.- Percentage of patients with counseling for physical activity.
Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents 0% 39
Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.- Percentage of patients with height, weight, and body mass index (BMI) percentile documentation.- Percentage of patients with counseling for nutrition.- Percentage of patients with counseling for physical activity.
Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents 0% 39
Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.- Percentage of patients with height, weight, and body mass index (BMI) percentile documentation.- Percentage of patients with counseling for nutrition.- Percentage of patients with counseling for physical activity.

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)

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 the step by step 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

Frequently Asked Questions

What is Dr. Samatha Kadiyala M.D. NPI number?

The NPI number assigned to this healthcare provider is 1003002627, registered as an "individual" on September 18, 2007

Where is Dr. Samatha Kadiyala M.D. located?

The provider is located at 506 This Way St Lake Jackson, Tx 77566 and the phone number is (979) 266-9544

Which is Dr. Samatha Kadiyala M.D. specialty?

The provider's speciality is Obstetrics & Gynecology

How many years of experience does Dr. Samatha Kadiyala M.D. have?

The provider has more than 22 years of experience.

What insurance does Dr. Samatha Kadiyala M.D. accept?

The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Is Dr. Samatha Kadiyala M.D. registered in PECOS?

Yes, as of March 13, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary 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.

What are Dr. Samatha Kadiyala M.D. Quality Ratings?

The provider has an overall high rating in the following quality measures: uses technology to exchange and make use of healthcare information. The provider obtained a high score in the following performance measures: Documentation of Current Medications in the Medical Record, e-Prescribing, Provide Patients Electronic Access to Their Health Information , Support Electronic Referral Loops By Sending Health Information. The quality ratings are based on unbiased reviews and reported submissions to Medicare's Quality Payment Program.

How much is a visit to Dr. Samatha Kadiyala M.D.?

Medicare beneficiaries should expect a typical cost of $136.68 with an average copayment of $34.17 for new patient appointments. Established patients should expect a typical charge of $74.68 and an average copayment of 18.67. Please review your insurance plan or contact the provider directly to determine your specific costs.

What are some of the services provided by Dr. Samatha Kadiyala M.D.?

The most common procedures or services performed by this practitioner are: Urinalysis, manual test, Cervical or vaginal cancer screening; pelvic and clinical breast examination, Stool analysis for blood to screen for colon tumors, Ultrasound measurement of bladder capacity after voiding, Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous, Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory and Ultrasound pelvis through vagina.

How do I update my NPI information?

The NPI record of Dr. Samatha Kadiyala M.D. was last updated on September 18, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
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