SWAPNA MADHAVAN M.D.
NPI 1205880309
Family Medicine in Cumming, GA

Q: What is Swapna Madhavan's NPI number?

The NPI number for Swapna Madhavan is 1205880309. It was assigned to this individual provider in the NPPES registry on May 22, 2006.

Q: What is Swapna Madhavan's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Swapna Madhavan was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since May 22, 2006PECOS EnrolledAccepts Medicare Assignment

260 ELM ST, CUMMING, GA 30040(770) 887-1668(779) 781-9937 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Swapna Madhavan M.d. NPPES

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

SWAPNA MADHAVAN M.D. (NPI 1205880309) is an individual family medicine provider in Cumming, Georgia, licensed in Georgia (057098) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1205880309

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameSWAPNA MADHAVANCredential: M.D.

Location Address260 ELM STCumming, GA 30040-2467

Mailing AddressPo Box 307Cumming, GA 30028-0307 · (770) 887-1668 · Fax (778) 781-9937

Phone(770) 887-1668

Fax(779) 781-9937

Sole ProprietorNo

Medical School CMSOtherGraduated 1998

Enumeration DateMay 22, 2006

Last NPPES UpdateMarch 7, 2023

✔ NPI 1205880309 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in GA · 057098

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

260 ELM ST, Cumming, GA 30040

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Other Identifiers 2

Other983802GA · Blue Corss/blue Shield #

Other057098GA · Ga Medical License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, 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

Swapna Madhavan 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 ID1557373958

PECOS Enrollment IDI20060630000073

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 2

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

Northside Hospital Forsyth

Acute Care Hospitals · Cumming, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110005

Location1200 Northside Forsyth DriveCumming, GA 30041 · Forsyth County

Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110161

Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30040 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

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

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.

MRS. KATHERINE WEAVER PMHNP-BC

Nurse Practitioner (Psychiatric/Mental Health)

260 ELM ST
CUMMING, GA 30040

Forsyth County (770) 887-1668

KRUPA PATEL FNP-C

Nurse Practitioner (Family)

260 ELM ST
CUMMING, GA 30040

Forsyth County (708) 871-6687

TOAN TRAN PHARMD

Pharmacist

260 ELM ST
CUMMING, GA 30040

Forsyth County (770) 887-1668

DR. FERNANDO R. ALVAREZ-BOGNAR M.D.

Internal Medicine

260 ELM ST
CUMMING, GA 30040

Forsyth County (770) 887-1668

GEORGIA HIGHLANDS MEDICAL SERVICES, INC.

Pharmacy (Community/Retail Pharmacy)

260 ELM ST
CUMMING, GA 30040

Forsyth County (770) 887-1670

MRS. DEBRA L IRVINE RN

Registered Nurse (Community Health)

260 ELM ST
CUMMING, GA 30040

Forsyth County (770) 887-1668

MRS. CAROL P LYERLY FNP-C

Nurse Practitioner (Family)

260 ELM ST
CUMMING, GA 30040

Forsyth County (770) 887-1668

DR. BRINKLEY F GOODSON D.O.

Family Medicine

260 ELM ST
CUMMING, GA 30040

Forsyth County (770) 887-1668

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 Swapna Madhavan's NPI number?

The NPI number for Swapna Madhavan is 1205880309. It was assigned to this individual provider in the NPPES registry on May 22, 2006.

Where is Swapna Madhavan located?

Swapna Madhavan practices at 260 Elm St, Cumming, GA 30040. The listed phone number is (770) 887-1668.

What is Swapna Madhavan's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Swapna Madhavan enrolled in Medicare?

Yes. Swapna Madhavan 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 Swapna Madhavan accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Swapna Madhavan 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 Swapna Madhavan affiliated with any hospitals?

According to CMS data, Swapna Madhavan is affiliated with Northside Hospital Forsyth and Northside Hospital.

When was this NPI record last updated?

The NPPES record for Swapna Madhavan was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.