Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

POOJITHA PATHAKAMUDI MD
NPI 1053044024
Internal Medicine in South Charleston, WV

Q: What is Poojitha Pathakamudi's NPI number?

The NPI number for Poojitha Pathakamudi is 1053044024. It was assigned to this individual provider in the NPPES registry on July 6, 2022.

Q: What is Poojitha Pathakamudi's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since July 06, 2022PECOS Enrolled

4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309(304) 766-3600 Get Directions Write a Review

NPPES record last updated: August 27, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Aug 27, 2026, Jul 6, 2022 (2 updates tracked since 2022).

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About Poojitha Pathakamudi Md NPPES

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

POOJITHA PATHAKAMUDI MD (NPI 1053044024) is an individual internal medicine provider in South Charleston, West Virginia, licensed in West Virginia (34758) and active in the NPI registry since July 2022. She is enrolled in Medicare PECOS, is affiliated with Thomas Memorial Hospital, and maintains a secondary practice location in New York.

NPPES Registry Identity

NPI1053044024

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NamePOOJITHA PATHAKAMUDICredential: MD

Location Address4605 MACCORKLE AVE SWSouth Charleston, WV 25309-1398

Mailing Address1955 1st Ave Apt 439New York, NY 10029-6443 · (212) 423-6271

Phone(304) 766-3600

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateJuly 6, 2022

Last NPPES UpdateAugust 27, 20262 updates tracked since enumeration

NPPES CertifiedAugust 27, 2026

✔ NPI 1053044024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in WV · 34758

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

4605 MACCORKLE AVE SW, South Charleston, WV 25309

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Secondary Practice Location 1

Location 11901 1st AveNew York, NY 10029-7494 · Phone (917) 603-4719

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.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

Poojitha Pathakamudi Md 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 ID3274055512

PECOS Enrollment IDI20250317002068

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.

Hospital Affiliations CMS Care Compare

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

Thomas Memorial Hospital

Acute Care Hospitals · South Charleston, WV

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number510029

Location4605 Maccorkle Avenue SWSouth Charleston, WV 25309 · Kanawha County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25309 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

$124.46 typical visit price

range $53.20 – $164.59

Typical copayment $31.11 (range $13.30 – $41.14)

Most-billed visit code 99204

Established Patient

$94.81 typical visit price

range $16.47 – $133.29

Typical copayment $23.70 (range $4.11 – $33.32)

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.

Other Providers at the Same Location NPPES 20

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

DUSTIN CRITES

Physician Assistant