PAVAN TUMMALA M.D.
NPI 1407111313
Psychiatry & Neurology - Neurology in Gainesville, GA

Active since July 06, 2012PECOS EnrolledAccepts Medicare Assignment
82.55/100
CMS Quality Rating
1315 JESSE JEWELL PKWY NE STE 300, GAINESVILLE, GA 30501(770) 219-6520 Get Directions Write a Review

NPPES record last updated: October 18, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 18, 2023, Jul 25, 2023, Dec 27, 2018 and 3 more (6 updates tracked since 2017).

About Pavan Tummala M.d. NPPES

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

PAVAN TUMMALA M.D. (NPI 1407111313) is an individual neurology provider in Gainesville, Georgia, licensed in Georgia (96271) and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS, is affiliated with Northeast Georgia Medical Center, Inc, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1407111313
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NamePAVAN TUMMALACredential: M.D.
Location Address1315 JESSE JEWELL PKWY NE STE 300Gainesville, GA 30501-3875
Mailing AddressPo Box 742616Atlanta, GA 30374-2616 · (770) 219-8420
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateJuly 6, 2012
Last NPPES UpdateOctober 18, 20236 updates tracked since enumeration
NPPES CertifiedOctober 18, 2023
NPI 1407111313 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
Licenses Licensed in GA · 96271 Licensed in MO · 2016026000
Definition

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

1315 JESSE JEWELL PKWY NE STE 300, Gainesville, GA 30501

Other Identifiers 2

Medicaid200028679MO
Medicaid1407111313MO

Accepted 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

Pavan Tummala 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.

PECOS PAC ID9234431610
PECOS Enrollment IDI20230802002461, I20241104003144
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 15

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.

Needle measurement of electrical activity in arm or leg muscles, complete study 95886
This procedure, known as an electromyography (EMG), involves inserting a small needle into your arm or leg muscles to measure their electrical activity. This complete study helps diagnose issues with nerves or muscles, providing valuable data for your treatment plan.
137 services137 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.
88 services73 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.
85 services85 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.
73 services59 patients
Measurement of brain wave activity (eeg), awake and drowsy 95816
Measurement of brain wave activity, also known as an EEG, is a non-invasive test that records electrical patterns in your brain. This procedure is done when you're awake and drowsy to understand how your brain functions during different states of consciousness.
70 services69 patients
Measurement of brain wave activity (eeg), awake and asleep 95819
The measurement of brain wave activity, known as an EEG, records the brain's electrical signals. It's performed when you're awake and asleep to monitor your brain's functioning. It helps in diagnosing conditions like epilepsy, sleep disorders, and other neurological issues.
62 services61 patients

Hospital Affiliations CMS Care Compare 5

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

Northeast Georgia Medical Center, Inc

Acute Care Hospitals · Gainesville, GA
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number110029
Location743 Spring StreetGainesville, GA 30501 · Hall County
Emergency services Birthing friendly

Ngmc Barrow, LLC

Acute Care Hospitals · Winder, GA
OwnershipProprietary
CMS Certification Number110045
Location316 North Broad StreetWinder, GA 30680 · Barrow County
Emergency services

Northeast Georgia Medical Center Lumpkin

Acute Care Hospitals · Dahlonega, GA
OwnershipVoluntary non-profit - Other
CMS Certification Number110237
Location495 Highway 400 NorthDahlonega, GA 30533 · Lumpkin County
Emergency services

St James Healthcare

Acute Care Hospitals · Butte, MT
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number270017
Location400 S Clark StButte, MT 59701 · Silver Bow County
Emergency services Birthing friendly

St Vincent Healthcare

Acute Care Hospitals · Billings, MT
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number270049
Location1233 N 30th StBillings, MT 59101 · Yellowstone County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30501 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

82.55/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.14
Promoting Interoperability100
Improvement Activities40
Cost60.7

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.

Nurse Practitioner (Family)
1315 JESSE JEWELL PKWY NE STE 300
GAINESVILLE, GA 30501
Orthopaedic Surgery
1315 JESSE JEWELL PKWY NE STE 300
GAINESVILLE, GA 30501
Clinical Neuropsychologist
1315 JESSE JEWELL PKWY NE STE 300
GAINESVILLE, GA 30501
Physician Assistant (Medical)
1315 JESSE JEWELL PKWY NE STE 300
GAINESVILLE, GA 30501
Family Medicine
1315 JESSE JEWELL PKWY NE STE 300
GAINESVILLE, GA 30501
Physician Assistant (Surgical)
1315 JESSE JEWELL PKWY NE STE 300
GAINESVILLE, GA 30501
Psychiatry & Neurology (Neurology)
1315 JESSE JEWELL PKWY NE STE 300
GAINESVILLE, GA 30501
Physician Assistant (Surgical)
1315 JESSE JEWELL PKWY NE STE 300
GAINESVILLE, GA 30501

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 Pavan Tummala's NPI number?

The NPI number for Pavan Tummala is 1407111313. It was assigned to this individual provider in the NPPES registry on July 6, 2012.

Where is Pavan Tummala located?

Pavan Tummala practices at 1315 Jesse Jewell Pkwy NE Ste 300, Gainesville, GA 30501. The listed phone number is (770) 219-6520.

What is Pavan Tummala's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Pavan Tummala enrolled in Medicare?

Yes. Pavan Tummala 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 Pavan Tummala accept?

Health plans from Alliant Health Plans, Inc., Blue Cross and Blue Shield of Montana, Mountain Health CO-OP and Providence Health Plan list Pavan Tummala 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 Pavan Tummala affiliated with any hospitals?

According to CMS data, Pavan Tummala is affiliated with Northeast Georgia Medical Center, Inc, Ngmc Barrow, LLC, Northeast Georgia Medical Center Lumpkin, St James Healthcare and St Vincent Healthcare.

When was this NPI record last updated?

The NPPES record for Pavan Tummala was last updated on October 18, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.