DR. SOUMYA CHOWDARY MADALA M.D.
NPI 1043334527
Internal Medicine - Sleep Medicine in Grand Rapids, MI

Active since March 19, 2007PECOS EnrolledAccepts Medicare Assignment
260 JEFFERSON AVE SE, STE 300, GRAND RAPIDS, MI 49503(616) 685-6330(616) 685-3010 Get Directions Write a Review

NPPES record last updated: December 3, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Soumya Chowdary Madala M.d. NPPES

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

DR. SOUMYA CHOWDARY MADALA M.D. (NPI 1043334527) is an individual sleep medicine provider in Grand Rapids, Michigan, licensed in Michigan (4301085495) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS, is affiliated with Mercy Health Saint Mary's, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1043334527
Entity TypeIndividualFemale
Primary Taxonomy207RS0012X
Provider Legal NameDR. SOUMYA CHOWDARY MADALACredential: M.D.
Location Address260 JEFFERSON AVE SE, STE 300Grand Rapids, MI 49503-4597
Mailing Address245 State St Se, Ste 228Grand Rapids, MI 49503-4328 · (616) 685-1808
Fax(616) 685-3010
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateMarch 19, 2007
Last NPPES UpdateDecember 3, 2021
NPPES CertifiedDecember 3, 2021
NPI 1043334527 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Sleep MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RS0012X
License Licensed in MI · 4301085495
Definition
An Internist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders.
Also ListedInternal MedicineTaxonomy 207R00000X · License 4301085495 (MI)
260 JEFFERSON AVE SE, Grand Rapids, MI 49503

Other Names 1

Former Name (1)Dr. Soumya Talasila M.d.

Accepted 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. Soumya Chowdary Madala 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 ID8325231590
PECOS Enrollment IDI20101020000466
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 6

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.

Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation G0399
A Home Sleep Test (HST) with a Type III Portable Monitor is an unattended test that records your breathing, heart rate, and oxygen levels during sleep. This test uses a minimum of 4 channels to monitor these parameters, helping to diagnose sleep disorders.
33 services33 patients
Sleep study in sleep lab (6 years or older) 95810
A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.
31 services28 patients
Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811
A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.
26 services24 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.
17 services16 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.
15 services14 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
14 services14 patients

Hospital Affiliations CMS Care Compare 3

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

Mercy Health Saint Mary's

Acute Care Hospitals · Grand Rapids, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230059
Location200 Jefferson Avenue SEGrand Rapids, MI 49503 · Kent County
Emergency services Birthing friendly

Trinity Health Muskegon Hospital

Acute Care Hospitals · Muskegon, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230066
Location1500 E Sherman BlvdMuskegon, MI 49441 · Muskegon County
Emergency services Birthing friendly

Trinity Health Grand Haven Hospital

Acute Care Hospitals · Grand Haven, MI
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number230174
Location1309 Sheldon RdGrand Haven, MI 49417 · Ottawa County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49503 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
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
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.

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report
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
47%43 patients2/55-star benchmark: 95%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%1,145 patients5/55-star benchmark: 100%
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%408 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.
74%1,134 patients4/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
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…
50%984 patients3/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
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
Patients screenedForUse: 96% · 139 patients
90%139 patients4/55-star benchmark: 98%
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…
100%1,134 patients5/55-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…
57%1,134 patients3/55-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.
60%1,134 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.

Referred Medical Equipment & Supplies CMS DME claims 18

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
22 suppliers151 claims151 services$31.59 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
20 suppliers126 claims126 services$71.97 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
19 suppliers141 claims316 services$28.03 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
11 suppliers46 claims188 services$13.63 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
7 suppliers30 claims142 services$11.63 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
12 suppliers85 claims85 services$42.36 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 9

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

Nurse Practitioner (Family)
260 JEFFERSON AVE SE, 206
GRAND RAPIDS, MI 49503
Internal Medicine
260 JEFFERSON AVE SE, SUITE 115
GRAND RAPIDS, MI 49503
Social Worker
260 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Peer Specialist
260 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Dentist
260 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Social Worker (Clinical)
260 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Social Worker (Clinical)
260 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Internal Medicine (Sleep Medicine)
260 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503

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 Soumya Madala's NPI number?

The NPI number for Soumya Madala is 1043334527. It was assigned to this individual provider in the NPPES registry on March 19, 2007. The provider is also known as Dr. Soumya Talasila M.D..

Where is Soumya Madala located?

Soumya Madala practices at 260 Jefferson Ave SE Ste 300, Grand Rapids, MI 49503. The listed phone number is (616) 685-6330.

What is Soumya Madala's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Sleep Medicine, with taxonomy code 207RS0012X.

Is Soumya Madala enrolled in Medicare?

Yes. Soumya Madala 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 Soumya Madala accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company and Priority Health list Soumya Madala 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 Soumya Madala affiliated with any hospitals?

According to CMS data, Soumya Madala is affiliated with Mercy Health Saint Mary's, Trinity Health Muskegon Hospital and Trinity Health Grand Haven Hospital.

When was this NPI record last updated?

The NPPES record for Soumya Madala was last updated on December 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.