Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

REVANTH POONDLA MD
NPI 1356043475
Family Medicine in Georgetown, TX

Q: What is Revanth Poondla's NPI number?

The NPI number for Revanth Poondla is 1356043475. It was assigned to this individual provider in the NPPES registry on March 21, 2023.

Q: What is Revanth Poondla'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 Revanth Poondla was last updated on September 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 46 days 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 March 21, 2023PECOS Enrolled

4945 WILLIAMS DR, GEORGETOWN, TX 78633(512) 819-0500(512) 819-0520 Get Directions Write a Review

NPPES record last updated: September 17, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 17, 2026, Nov 20, 2025, Mar 21, 2023 (3 updates tracked since 2023).

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About Revanth Poondla Md NPPES

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

REVANTH POONDLA MD (NPI 1356043475) is an individual family medicine provider in Georgetown, Texas, licensed in Texas (V9100) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS, is affiliated with Baylor Scott & White Medical Center - Round Rock, and maintains a secondary practice location in Round Rock.

NPPES Registry Identity

NPI1356043475

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameREVANTH POONDLACredential: MD

Location Address4945 WILLIAMS DRGeorgetown, TX 78633-2008

Mailing AddressPo Box 844658Dallas, TX 75284-4658 · (800) 994-0371 · Fax (254) 215-9722

Phone(512) 819-0500

Fax(512) 819-0520

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateMarch 21, 2023

Last NPPES UpdateSeptember 17, 20263 updates tracked since enumeration

NPPES CertifiedSeptember 17, 2026

✔ NPI 1356043475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in TX · V9100

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.

4945 WILLIAMS DR, Georgetown, TX 78633

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Secondary Practice Location 1

Location 1425 University Blvd Ste 500Round Rock, TX 78665-1047 · Phone (512) 509-3404

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Revanth Poondla Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8628575115

PECOS Enrollment IDI20251009003301

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 Revanth Poondla reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Scott & White Clinic

18 mi

Internal Medicine

1701 E PFLUGERVILLE PKWY
Pflugerville, TX 78660

Reassigned Medicare billing, Texas enrollment
2,795 clinicians in this Medicare group

NPI 1679691729 (512) 259-6000

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

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

Baylor Scott & White Medical Center - Round Rock

Acute Care Hospitals · Round Rock, TX

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number670034

Location300 University BlvdRound Rock, TX 78664 · Williamson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78633 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

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

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.

BAYLOR SCOTT & WHITE HEALTH ENTERPRISES, INC.

Pharmacy (Community/Retail Pharmacy)