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DR. SAMBA SIVA REDDY BATHULA M.D
NPI 1013223239
Otolaryngology in Detroit, MI

Active since August 25, 2010PECOS EnrolledAccepts Medicare Assignment
80.59/100
CMS Quality Rating
4160 JOHN R ST STE 1007, DMC ENT-HARPER PROFESSIONAL BUILDING, DETROIT, MI 48201(313) 966-9471(313) 966-9470 Get Directions Write a Review

NPPES record last updated: May 30, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Samba Siva Reddy Bathula M.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SAMBA SIVA REDDY BATHULA M.D (NPI 1013223239) is an individual otolaryngology provider in Detroit, Michigan, licensed in Michigan (4301096231) and active in the NPI registry since August 2010. He is enrolled in Medicare PECOS, is affiliated with Sinai-grace Hospital, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1013223239
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameDR. SAMBA SIVA REDDY BATHULACredential: M.D
Location Address4160 JOHN R ST STE 1007, DMC ENT-HARPER PROFESSIONAL BUILDINGDetroit, MI 48201-2017
Mailing Address4160 John R St Ste 1007, Dmc Ent-harper Professional BuildingDetroit, MI 48201-2017 · (313) 966-9471 · Fax (313) 966-9470
Phone(313) 966-9471
Fax(313) 966-9470
Sole ProprietorYes
Medical School CMSOtherGraduated 1998
Enumeration DateAugust 25, 2010
Last NPPES UpdateMay 30, 2015
✔ NPI 1013223239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in MI · 4301096231
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Also ListedOtolaryngology · Pediatric OtolaryngologyTaxonomy 207YP0228X · License 4301096231 (MI)
4160 JOHN R ST STE 1007, Detroit, MI 48201
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Samba Siva Reddy Bathula M.d is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8527204817
PECOS Enrollment IDI20130410000512
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 14

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
114 services50 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
75 services54 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
72 services44 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
67 services65 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
37 services28 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
33 services30 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Sinai-Grace Hospital

Acute Care Hospitals · Detroit, MI
1/5 CMS rating
OwnershipProprietary
CMS Certification Number230024
Location6071 W Outer DriveDetroit, MI 48235 · Wayne County
Emergency services Birthing friendly

Harper University Hospital

Acute Care Hospitals · Detroit, MI
1/5 CMS rating
OwnershipProprietary
CMS Certification Number230104
Location3990 John R StreetDetroit, MI 48201 · Wayne County
Emergency services Birthing friendly

Detroit Receiving Hospital

Acute Care Hospitals · Detroit, MI
1/5 CMS rating
OwnershipProprietary
CMS Certification Number230273
Location4201 St Antoine St - 2CDetroit, MI 48201 · Wayne County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48201 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$134.28 typical visit price
range $58.04 – $177.36
Typical copayment $33.57 (range $14.51 – $44.34)
Most-billed visit code 99204
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

80.59/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality53.55
Promoting Interoperability100
Improvement Activities40
Cost52.03

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
83%306 patients2/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%312 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
8%515 patients1/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
98%515 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
2%515 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
10%515 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRIAN YOUNG
Student in an Organized Health Care Education/Training Program
4160 JOHN R ST STE 1007
DETROIT, MI 48201
Wayne County (313) 966-9471
MEGAN E SHARO AUD
Audiologist
4160 JOHN R ST STE 1007
DETROIT, MI 48201
Wayne County (313) 966-9471
ANDREW EDWARD ROSS
Otolaryngology
4160 JOHN R ST STE 1007
DETROIT, MI 48201
Wayne County (313) 966-9471

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samba Siva Reddy Bathula's NPI number?

The NPI number for Samba Siva Reddy Bathula is 1013223239. It was assigned to this individual provider in the NPPES registry on August 25, 2010.

Where is Samba Siva Reddy Bathula located?

Samba Siva Reddy Bathula practices at 4160 John R St Ste 1007 Dmc Ent-Harper Professional Building, Detroit, MI 48201. The listed phone number is (313) 966-9471.

What is Samba Siva Reddy Bathula's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Samba Siva Reddy Bathula enrolled in Medicare?

Yes. Samba Siva Reddy Bathula is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Samba Siva Reddy Bathula accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 3 other insurers list Samba Siva Reddy Bathula as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Samba Siva Reddy Bathula affiliated with any hospitals?

According to CMS data, Samba Siva Reddy Bathula is affiliated with Sinai-Grace Hospital, Harper University Hospital and Detroit Receiving Hospital.

When was this NPI record last updated?

The NPPES record for Samba Siva Reddy Bathula was last updated on May 30, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.