NISHANTH VALLUMSETLA
NPI 1134589799
Internal Medicine - Pulmonary Disease in Scranton, PA

Q: What is Nishanth Vallumsetla's NPI number?

The NPI number for Nishanth Vallumsetla is 1134589799. It was assigned to this individual provider in the NPPES registry on February 25, 2016.

Q: What is Nishanth Vallumsetla's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Active since February 25, 2016PECOS EnrolledAccepts Medicare Assignment

300 LACKAWANNA AVE STE 200, SCRANTON, PA 18503(570) 342-7864 Get Directions Write a Review

NPPES record last updated: November 10, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 10, 2025, Aug 15, 2023, Mar 22, 2016 and 1 more (4 updates tracked since 2016).

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About Nishanth Vallumsetla NPPES

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

NISHANTH VALLUMSETLA (NPI 1134589799) is an individual pulmonary disease provider in Scranton, Pennsylvania, licensed in Pennsylvania (MD490850) and active in the NPI registry since February 2016. He is enrolled in Medicare PECOS, is affiliated with Lehigh Valley Hospital - Pocono, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1134589799

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameNISHANTH VALLUMSETLA

Location Address300 LACKAWANNA AVE STE 200Scranton, PA 18503-2001

Mailing Address2100 Mack Blvd Fl 4Allentown, PA 18103-5622

Phone(570) 342-7864

Sole ProprietorNo

Medical School CMSOtherGraduated 2011

Enumeration DateFebruary 25, 2016

Last NPPES UpdateNovember 10, 20254 updates tracked since enumeration

NPPES CertifiedNovember 10, 2025

✔ NPI 1134589799 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

Licenses✔ Licensed in PA · MD490850✔ Licensed in IL · 0.36159074

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

300 LACKAWANNA AVE STE 200, Scranton, PA 18503

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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 Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nishanth Vallumsetla 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 ID7911387964

PECOS Enrollment IDI20260130000368

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.

Medicare Billing Reassignment

Medicare enrollment records show Nishanth Vallumsetla reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Lehigh Valley Physician Group

Same address

Gastroenterology

300 LACKAWANNA AVE STE 200
Scranton, PA 18503

Reassigned Medicare billing, Pennsylvania enrollment
2,895 clinicians in this Medicare group

NPI 1083339741 (570) 342-7864

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 13

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.

58 services24 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

50 services50 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

50 services50 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

42 services42 patients

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.

38 services20 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.

34 services21 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.

24 services15 patients

Test to measure expiratory airflow and volume 94010

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

20 services20 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.

18 services15 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.

16 services15 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.

13 services13 patients

Critical care, each additional 30 minutes 99292

Critical care refers to special attention given to patients facing life-threatening conditions. Each additional 30 minutes indicates the extension of this specialized care. This might include close monitoring, medication adjustments, and immediate interventions as needed.

13 services13 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.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Lehigh Valley Hospital - Pocono

Acute Care Hospitals · East Stroudsburg, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390201

Location206 East Brown StreetEast Stroudsburg, PA 18301 · Monroe County

Emergency services Birthing friendly

Geisinger Wyoming Valley Medical Center

Acute Care Hospitals · Wilkes Barre, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390270

Location1000 East Mountain BoulevardWilkes Barre, PA 18711 · Luzerne County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18503 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.

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.

LEHIGH VALLEY SPECIALTY PHYSICIAN GROUP

Surgery