CHANDRA KUMAR MALLIC KODAVANTI MD
NPI 1093236580
Internal Medicine - Critical Care Medicine in Dothan, AL

Q: What is Chandra Kumar Mallic Kodavanti's NPI number?

The NPI number for Chandra Kumar Mallic Kodavanti is 1093236580. It was assigned to this individual provider in the NPPES registry on July 5, 2017.

Q: What is Chandra Kumar Mallic Kodavanti's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Active since July 05, 2017PECOS EnrolledAccepts Medicare Assignment

97.58/100

CMS Quality Rating

1108 ROSS CLARK CIR, DOTHAN, AL 36301(334) 703-8836(334) 712-3512 Get Directions Write a Review

NPPES record last updated: July 25, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 25, 2023, Jul 21, 2022, Jun 24, 2020 and 2 more (5 updates tracked since 2017).

On this page

About Chandra Kumar Mallic Kodavanti Md NPPES

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

CHANDRA KUMAR MALLIC KODAVANTI MD (NPI 1093236580) is an individual critical care medicine provider in Dothan, Alabama, licensed in Alabama (MD.46417) and active in the NPI registry since July 2017. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1093236580

Entity TypeIndividualMale

Primary Taxonomy207RC0200X

Provider Legal NameCHANDRA KUMAR MALLIC KODAVANTICredential: MD

Location Address1108 ROSS CLARK CIRDothan, AL 36301-3022

Mailing AddressPo Box 1928Dothan, AL 36302-1928

Phone(334) 703-8836

Fax(334) 712-3512

Sole ProprietorNo

Medical School CMSOtherGraduated 2011

Enumeration DateJuly 5, 2017

Last NPPES UpdateJuly 25, 20235 updates tracked since enumeration

NPPES CertifiedJuly 25, 2023

✔ NPI 1093236580 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RC0200X

License✔ Licensed in AL · MD.46417

Definition

An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License RS2020-0463 (NM), BP10060414 (TX)

1108 ROSS CLARK CIR, Dothan, AL 36301

Open in Google Maps ↗

Secondary Practice Locations 2

Location 1Msc 10-5550 1 University Of New MexicoAlbuquerque, NM 87131-0001 · Phone (505) 272-4751 · Fax (505) 272-8700

Location 2701 W 5th StOdessa, TX 79763-4206 · Phone (432) 703-5375

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Magnolia Health, Ambetter Health, Ambetter of Alabama 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

Chandra Kumar Mallic Kodavanti 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 ID7214209808

PECOS Enrollment IDI20230816001998

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 5

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.

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

540 services124 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.

145 services44 patients

Insertion of artery tube for blood sampling or infusion through skin 36620

This procedure involves placing a small tube into an artery, usually in the wrist or elbow, to collect blood samples or administer medication. It's done under local anesthesia and is a common, safe practice.

43 services37 patients

Insertion of non-tunneled central venous tube for infusion (5 years or older) 36556

This procedure involves placing a thin tube into a large vein, usually in the neck or chest, to administer medication or fluids. It's done under local anesthesia to minimize discomfort. It's a standard, safe procedure for individuals aged 5 and above.

19 services18 patients

Ultrasonic guidance for blood vessel access 76937

Ultrasonic guidance for blood vessel access is a medical procedure where sound waves are used to create images of your blood vessels. This helps doctors to accurately locate and access the vessels for treatments or tests, ensuring safety and precision.

17 services17 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36301 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

$122.31 typical visit price

range $52.65 – $161.63

Typical copayment $30.57 (range $13.16 – $40.40)

Most-billed visit code 99204

Established Patient

$93.72 typical visit price

range $16.56 – $131.65

Typical copayment $23.43 (range $4.14 – $32.91)

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.

97.58/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

86.53

Promoting Interoperability

100

Improvement Activities

Leave this field empty

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.

DAVID TYLER WARREN M.D.

Anesthesiology