SWAPNA MADHAVAN M.D.
NPI 1205880309
Family Medicine in Cumming, GA
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
Specialties & Licenses
Other Identifiers 2
Accepted 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
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.
Medicare Billing Reassignment
Medicare enrollment records show Swapna Madhavan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Cumming, GA 30040
- Reassigned Medicare billing, Georgia enrollment
- 27 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, GANorthside Hospital
Acute Care Hospitals · Atlanta, GAPhysician 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.
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.
CUMMING, GA 30040
CUMMING, GA 30040
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.
Which organization bills Medicare for Swapna Madhavan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Swapna Madhavan reassigns Medicare benefits to Georgia Highlands Medical Services, Inc. (Cumming, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Swapna Madhavan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Swapna Madhavan accept?
Health plans from Oscar Health 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.
# Swapna Madhavan, M.D. · NPI 1205880309
Family Medicine physician in Cumming, Georgia. Individual provider, active in the CMS NPPES registry since May 22, 2006.
## Identity
- **NPI:** 1205880309 (Entity type: Individual)
- **Enumerated:** May 22, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 057098 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 260 ELM ST, Cumming, GA 30040-2467
- **Phone:** (770) 887-1668 · **Fax:** (779) 781-9937
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Georgia Highlands Medical Services, Inc. (NPI 1174529192, Cumming, GA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1998
## Record status
- **NPPES last updated:** March 7, 2023
- **Other identifiers:** Other 983802 (GA); Other 057098 (GA)
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Source: [NPI Profile](https://npiprofile.com/npi/1205880309) · Data from the CMS NPPES public registry.