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HEMA VENIGALLA MD
NPI 1386155661
Psychiatry & Neurology - Psychiatry in Scranton, PA

Active since October 13, 2017PECOS EnrolledAccepts Medicare Assignment
91.41/100
CMS Quality Rating
111 N WASHINGTON AVE, SCRANTON, PA 18503(570) 343-2383 Get Directions Write a Review

NPPES record last updated: January 25, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 25, 2022, Jul 11, 2019, Oct 13, 2017 (3 updates tracked since 2017).

About Hema Venigalla Md NPPES

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

HEMA VENIGALLA MD (NPI 1386155661) is an individual psychiatry provider in Scranton, Pennsylvania, licensed in Massachusetts (290213) and active in the NPI registry since October 2017. She is enrolled in Medicare PECOS, is affiliated with Northeast Hospital Corporation, and maintains a secondary practice location in Burlington.

NPPES Registry Identity

NPI1386155661
Entity TypeIndividualFemale
Primary Taxonomy2084P0800X
Provider Legal NameHEMA VENIGALLACredential: MD
Location Address111 N WASHINGTON AVEScranton, PA 18503-1828
Mailing Address1205 Hancock St Apt 802Quincy, MA 02169-4357 · (407) 403-2997 · Fax (570) 343-4800
Phone(570) 343-2383
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateOctober 13, 2017
Last NPPES UpdateJanuary 25, 20223 updates tracked since enumeration
NPPES CertifiedJanuary 25, 2022
✔ NPI 1386155661 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
Licenses✔ Licensed in MA · 290213✔ Licensed in PA · MT214695
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
111 N WASHINGTON AVE, Scranton, PA 18503
Open in Google Maps ↗

Secondary Practice Location 1

Location 141 Mall RdBurlington, MA 01805-1828 · Phone (781) 744-8000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care.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

Hema Venigalla 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 ID8022375450
PECOS Enrollment IDI20220209000096
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 5

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.
145 services69 patients
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.
130 services58 patients
Psychiatric diagnostic evaluation with medical services 90792
A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
48 services48 patients
Psychotherapy with evaluation and management visit, 30 minutes 90833
Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.
29 services16 patients
Psychiatric diagnostic evaluation with medical services 90792
A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
24 services24 patients

Hospital Affiliations CMS Care Compare 2

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

Northeast Hospital Corporation

Acute Care Hospitals · Beverly, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220033
Location85 Herrick StreetBeverly, MA 01915 · Essex County
Emergency services Birthing friendly

Lahey Hospital & Medical Center, Burlington

Acute Care Hospitals · Burlington, MA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220171
Location41 & 45 Mall RoadBurlington, MA 01803 · Middlesex County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18503 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
$166.87 typical visit price
range $54.64 – $166.87
Typical copayment $41.71 (range $13.66 – $41.71)
Most-billed visit code 99205
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
Most-billed visit code 99213
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.

91.41/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality76.87
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 4

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

ANISA SUGANTAL SUPARMANIAN
Psychiatry & Neurology (Psychiatry)
111 N WASHINGTON AVE
SCRANTON, PA 18503
Lackawanna County (570) 343-2383
DANISH A HAQUE MD
Internal Medicine
111 N WASHINGTON AVE
SCRANTON, PA 18503
Lackawanna County (570) 591-5153
MUZAMMAL SAEED CHAUDHRY MD
Family Medicine
111 N WASHINGTON AVE
SCRANTON, PA 18503
Lackawanna County (570) 343-2383
MIAOBING WU MD
Internal Medicine
111 N WASHINGTON AVE
SCRANTON, PA 18503
Lackawanna County (570) 343-2383

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 Hema Venigalla's NPI number?

The NPI number for Hema Venigalla is 1386155661. It was assigned to this individual provider in the NPPES registry on October 13, 2017.

Where is Hema Venigalla located?

Hema Venigalla practices at 111 N Washington Ave, Scranton, PA 18503. The listed phone number is (570) 343-2383.

What is Hema Venigalla's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Hema Venigalla enrolled in Medicare?

Yes. Hema Venigalla 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 Hema Venigalla accept?

Health plans from Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield and Harvard Pilgrim Health Care list Hema Venigalla 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 Hema Venigalla affiliated with any hospitals?

According to CMS data, Hema Venigalla is affiliated with Northeast Hospital Corporation and Lahey Hospital & Medical Center, Burlington.

When was this NPI record last updated?

The NPPES record for Hema Venigalla was last updated on January 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.