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PRITI PANDYA MD
NPI 1316910615
Internal Medicine - Gastroenterology in Smyrna, GA

Active since February 08, 2006PECOS EnrolledAccepts Medicare Assignment
92.93/100
CMS Quality Rating
4441 ATLANTA RD SE STE 204, SMYRNA, GA 30080(678) 741-5000(770) 739-2318 Get Directions Write a Review

NPPES record last updated: May 31, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Priti Pandya Md NPPES

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

PRITI PANDYA MD (NPI 1316910615) is an individual gastroenterology provider in Smyrna, Georgia, licensed in Georgia (054081) and active in the NPI registry since February 2006. She is enrolled in Medicare PECOS, is affiliated with Wellstar Kennestone Regional Medical Center, and is a graduate of Other (1995).

NPPES Registry Identity

NPI1316910615
Entity TypeIndividualFemale
Primary Taxonomy207RG0100X
Provider Legal NamePRITI PANDYACredential: MD
Location Address4441 ATLANTA RD SE STE 204Smyrna, GA 30080
Mailing Address711 Canton Rd Ne Ste 300Marietta, GA 30060-8949 · (678) 741-5000 · Fax (678) 819-4280
Phone(678) 741-5000
Fax(770) 739-2318
Sole ProprietorNo
Medical School CMSOtherGraduated 1995
Enumeration DateFebruary 8, 2006
Last NPPES UpdateMay 31, 2018
✔ NPI 1316910615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in GA · 054081
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
Also ListedSpecialistTaxonomy 174400000X · License 054081 (GA)
4441 ATLANTA RD SE STE 204, Smyrna, GA 30080
Open in Google Maps ↗

Other Identifiers 1

Medicaid054788195AGA

Accepted Insurance

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

Priti Pandya 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 ID2860386224
PECOS Enrollment IDI20040209000595
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 10

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.
184 services132 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.
83 services70 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
80 services79 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
73 services72 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.
73 services53 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.
53 services53 patients

Hospital Affiliations CMS Care Compare 5

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

Wellstar Kennestone Regional Medical Center

Acute Care Hospitals · Marietta, GA
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110035
Location677 Church StreetMarietta, GA 30060 · Cobb County
Emergency services Birthing friendly

Wellstar Paulding Medical Center

Acute Care Hospitals · Hiram, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110042
Location2518 Jimmy Lee Smith ParkwayHiram, GA 30141 · Paulding County

Wellstar Cobb Medical Center

Acute Care Hospitals · Austell, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110143
Location3950 Austell RdAustell, GA 30106 · Cobb County
Birthing friendly

Wellstar Douglas Medical Center

Acute Care Hospitals · Douglasville, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110184
Location8954 Hospital DriveDouglasville, GA 30134 · Douglas County
Emergency services Birthing friendly

Wellstar North Fulton Hospital

Acute Care Hospitals · Roswell, GA
2/5 CMS rating
OwnershipProprietary
CMS Certification Number110198
Location3000 Hospital BoulevardRoswell, GA 30076 · Fulton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30080 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
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.

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.

92.93/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.38
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 3

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

FRANCISCO J CARDENAS MD
Internal Medicine (Gastroenterology)
4441 ATLANTA RD SE STE 204
SMYRNA, GA 30080
Cobb County (678) 741-5000
SUBODH K LAL MD
Internal Medicine (Gastroenterology)
4441 ATLANTA RD SE STE 204
SMYRNA, GA 30080
Cobb County (678) 741-5000
SHANI WOOLARD CLAY M.D.
Internal Medicine (Gastroenterology)
4441 ATLANTA RD SE STE 204
SMYRNA, GA 30080
Cobb County (470) 267-1760

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 Priti Pandya's NPI number?

The NPI number for Priti Pandya is 1316910615. It was assigned to this individual provider in the NPPES registry on February 8, 2006.

Where is Priti Pandya located?

Priti Pandya practices at 4441 Atlanta Rd SE Ste 204, Smyrna, GA 30080. The listed phone number is (678) 741-5000.

What is Priti Pandya's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Priti Pandya enrolled in Medicare?

Yes. Priti Pandya 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 Priti Pandya accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Priti Pandya 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 Priti Pandya affiliated with any hospitals?

According to CMS data, Priti Pandya is affiliated with Wellstar Kennestone Regional Medical Center, Wellstar Paulding Medical Center, Wellstar Cobb Medical Center, Wellstar Douglas Medical Center and Wellstar North Fulton Hospital.

When was this NPI record last updated?

The NPPES record for Priti Pandya was last updated on May 31, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.