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PRAVEENA GANDIKOTA MD
NPI 1285849513
Internal Medicine - Endocrinology, Diabetes & Metabolism in Upland, PA

Active since May 11, 2007PECOS EnrolledAccepts Medicare Assignment
ONE MEDICAL CENTER BLVD, SUITE 424, UPLAND, PA 19013(610) 338-1820(610) 338-1825 Get Directions Write a Review

NPPES record last updated: October 29, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Praveena Gandikota Md NPPES

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

PRAVEENA GANDIKOTA MD (NPI 1285849513) is an individual endocrinology, diabetes & metabolism provider in Upland, Pennsylvania, licensed in Pennsylvania (MD440569) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS, is affiliated with Paoli Hospital, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1285849513
Entity TypeIndividualFemale
Primary Taxonomy207RE0101X
Provider Legal NamePRAVEENA GANDIKOTACredential: MD
Location AddressONE MEDICAL CENTER BLVD, SUITE 424Upland, PA 19013
Mailing AddressOne Medical Center Blvd, Suite 424Upland, PA 19013 · (610) 338-1820 · Fax (610) 338-1825
Phone(610) 338-1820
Fax(610) 338-1825
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateMay 11, 2007
Last NPPES UpdateOctober 29, 2012
✔ NPI 1285849513 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in PA · MD440569
Definition

An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License MT 185538 (PA)
ONE MEDICAL CENTER BLVD, Upland, PA 19013
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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 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

Praveena Gandikota 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 ID547459869
PECOS Enrollment IDI20110118000587
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 3

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.

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.
542 services299 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.
194 services156 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
170 services75 patients

Hospital Affiliations CMS Care Compare 4

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

Paoli Hospital

Acute Care Hospitals · Paoli, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390153
Location255 West Lancaster AvenuePaoli, PA 19301 · Chester County
Emergency services Birthing friendly

Main Line Hospital Lankenau

Acute Care Hospitals · Wynnewood, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390195
Location100 Lancaster AveWynnewood, PA 19096 · Montgomery County
Emergency services Birthing friendly

Riddle Memorial Hospital

Acute Care Hospitals · Media, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390222
Location1068 West Baltimore PikeMedia, PA 19063 · Delaware County
Emergency services Birthing friendly

Einstein Medical Center Montgomery

Acute Care Hospitals · East Norriton, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390329
Location559 West Germantown PikeEast Norriton, PA 19403 · Montgomery County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19013 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
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
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 10

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

Supplies for maintenance of insulin infusion catheter, per week A4224
DME-Other DME · category DE017N
7 suppliers68 claims869 services$17.88 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
7 suppliers71 claims2,294 services$2.36 avg. paid by Medicare
Supply allowance for adjunctive continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service A4238
DME-Medical/Surgical Supplies · category DA000N
3 suppliers24 claims24 services$174.75 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
66 suppliers318 claims1,120 services$5.81 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
3 suppliers13 claims13 services$2.95 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
41 suppliers142 claims273 services$1.05 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 20

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

SURGICAL CARE ASSOCIATES
Surgery
ONE MEDICAL CENTER BLVD, SUITE 241
UPLAND, PA 19013
Delaware County (610) 619-7400
MS. JENNIFER A HARTLE P.A.
Physician Assistant
ONE MEDICAL CENTER BLVD, CCMC, POB II, SUITE 324
UPLAND, PA 19013
Delaware County (610) 876-0347
MR. PETER JOHN GUZZETTI RPH
Pharmacist
ONE MEDICAL CENTER BLVD
UPLAND, PA 19013
Delaware County (610) 338-8249
DR. ARLIN JOEL SILBERMAN D.O.
Psychiatry & Neurology (Addiction Psychiatry)
ONE MEDICAL CENTER BLVD, PSYCHIATRY DEPT, CROZER CHESTER MEDICAL CENTER
UPLAND, PA 19013
Delaware County (610) 874-5257
CROZER CHESTER MEDICAL CENTER
General Acute Care Hospital
ONE MEDICAL CENTER BLVD, ACP 332
UPLAND, PA 19013
Delaware County (610) 447-7612
DR. CALVIN RANDOLPH STAFFORD JR. MD
Psychiatry & Neurology (Neurology)
ONE MEDICAL CENTER BLVD, SUITE 533
UPLAND, PA 19013
Delaware County (610) 619-7475
INGRAM M ROBERTS MD
Internal Medicine (Gastroenterology)
ONE MEDICAL CENTER BLVD, SUITE 231
UPLAND, PA 19013
Delaware County (610) 619-7475
DR. ANNE M RAUNIO MD
Obstetrics & Gynecology (Gynecology)
ONE MEDICAL CENTER BLVD, SUITE 333
UPLAND, PA 19013
Delaware County (610) 872-4900

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 Praveena Gandikota's NPI number?

The NPI number for Praveena Gandikota is 1285849513. It was assigned to this individual provider in the NPPES registry on May 11, 2007.

Where is Praveena Gandikota located?

Praveena Gandikota practices at One Medical Center Blvd Suite 424, Upland, PA 19013. The listed phone number is (610) 338-1820.

What is Praveena Gandikota's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Praveena Gandikota enrolled in Medicare?

Yes. Praveena Gandikota 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 Praveena Gandikota accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Buckeye Health Plan and Highmark Blue Cross Blue Shield Delaware list Praveena Gandikota 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 Praveena Gandikota affiliated with any hospitals?

According to CMS data, Praveena Gandikota is affiliated with Paoli Hospital, Main Line Hospital Lankenau, Riddle Memorial Hospital and Einstein Medical Center Montgomery.

When was this NPI record last updated?

The NPPES record for Praveena Gandikota was last updated on October 29, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.