1. Home
  2. Directory
  3. Pennsylvania
  4. Greensburg
  5. Internal Medicine
  6. NPI Profile

GAUTAM AGRAWAL M.D , M.P.H
NPI 1063737070
Internal Medicine - Nephrology in Greensburg, PA

Active since April 01, 2010PECOS EnrolledAccepts Medicare Assignment
1275 S MAIN ST STE 202, GREENSBURG, PA 15601(724) 836-8303(724) 836-8311 Get Directions Write a Review

NPPES record last updated: May 17, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 17, 2024, Apr 2, 2021 (2 updates tracked since 2021).

About Gautam Agrawal M.d , M.p.h NPPES

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

GAUTAM AGRAWAL M.D , M.P.H (NPI 1063737070) is an individual nephrology provider in Greensburg, Pennsylvania, licensed in Pennsylvania (MD454638) and active in the NPI registry since April 2010. He is enrolled in Medicare PECOS, is affiliated with Excela Health Westmoreland Regional Hospital, and maintains a secondary practice location in Mt Pleasant.

NPPES Registry Identity

NPI1063737070
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameGAUTAM AGRAWALCredential: M.D , M.P.H
Location Address1275 S MAIN ST STE 202Greensburg, PA 15601-5385
Mailing Address575 Coal Valley Rd Ste 204Clairton, PA 15025-3724 · (412) 466-2220 · Fax (412) 466-4048
Phone(724) 836-8303
Fax(724) 836-8311
Sole ProprietorNo
Medical School CMSUniversity Of Alabama School Of MedicineGraduated 2010
Enumeration DateApril 1, 2010
Last NPPES UpdateMay 17, 20242 updates tracked since enumeration
NPPES CertifiedMay 17, 2024
✔ NPI 1063737070 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in PA · MD454638
Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

1275 S MAIN ST STE 202, Greensburg, PA 15601
Open in Google Maps ↗

Secondary Practice Location 1

Location 12000 Summit Ridge PlzMT Pleasant, PA 15666-1908 · Phone (724) 836-8303 · Fax (724) 836-8311

Other Identifiers 1

Medicaid1030258100007PA

Accepted Insurance

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

Gautam Agrawal M.d , M.p.h 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 ID5193959302
PECOS Enrollment IDI20150813009375
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 10

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.
278 services76 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
203 services32 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.
195 services120 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
91 services30 patients
Hemodialysis procedure with physician evaluation 90935
Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.
71 services19 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
52 services32 patients

Hospital Affiliations CMS Care Compare 4

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

Excela Health Westmoreland Regional Hospital

Acute Care Hospitals · Greensburg, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390145
Location532 West Pittsburgh StreetGreensburg, PA 15601 · Westmoreland County
Emergency services Birthing friendly

Penn Highlands Connellsville

Acute Care Hospitals · Connellsville, PA
OwnershipVoluntary non-profit - Private
CMS Certification Number390184
Location401 East Murphy AvenueConnellsville, PA 15425 · Fayette County
Emergency services

Excela Health - Frick Hospital

Acute Care Hospitals · Mount Pleasant, PA
OwnershipVoluntary non-profit - Other
CMS Certification Number390217
Location508 South Church StreetMount Pleasant, PA 15666 · Westmoreland County
Emergency services

Excela Health Latrobe Hospital

Acute Care Hospitals · Latrobe, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390219
LocationOne Mellon WayLatrobe, PA 15650 · Westmoreland County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15601 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

Referred Medical Equipment & Supplies CMS DME claims 4

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

Azathioprine, oral, 50 mg J7500
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier12 claims360 services$1.88 avg. paid by Medicare
Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers28 claims2,040 services$0.30 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
3 suppliers22 claims22 services$17.20 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
2 suppliers31 claims31 services$11.41 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 2

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

JUSTIN JEFFRIES CRNP
Nurse Practitioner
1275 S MAIN ST STE 202
GREENSBURG, PA 15601
Westmoreland County (724) 836-8303
STEPHANIE KUHNS CRNP
Nurse Practitioner
1275 S MAIN ST STE 202
GREENSBURG, PA 15601
Westmoreland County (724) 836-8303

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 Gautam Agrawal's NPI number?

The NPI number for Gautam Agrawal is 1063737070. It was assigned to this individual provider in the NPPES registry on April 1, 2010.

Where is Gautam Agrawal located?

Gautam Agrawal practices at 1275 S Main St Ste 202, Greensburg, PA 15601. The listed phone number is (724) 836-8303.

What is Gautam Agrawal's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Gautam Agrawal enrolled in Medicare?

Yes. Gautam Agrawal 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 Gautam Agrawal accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Gautam Agrawal 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 Gautam Agrawal affiliated with any hospitals?

According to CMS data, Gautam Agrawal is affiliated with Excela Health Westmoreland Regional Hospital, Penn Highlands Connellsville, Excela Health - Frick Hospital and Excela Health Latrobe Hospital.

When was this NPI record last updated?

The NPPES record for Gautam Agrawal was last updated on May 17, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.