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

Q: 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.

Q: What is Pavan Tummala's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Pavan Tummala was last updated on October 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

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: October 18, 2026.

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

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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 maintains a secondary practice location in Springfield.

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

Phone(770) 219-6520

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

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Secondary Practice Location 1

Location 11000 E Primrose StSpringfield, MO 65807-5154 · Phone (417) 269-1010

Other Identifiers 2

Medicaid200028679MO

Medicaid1407111313MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Blue Cross and Blue Shield of Montana, Mountain Health CO-OP and more.Insurance ›

Medicare Participation & PECOS CMS

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

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, I20241204001211, I20241206003041

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 Reassignments

Medicare enrollment records show Pavan Tummala reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Northeast Georgia Physicians Group Inc

0.4 mi

Family Medicine

743 SPRING ST NE
Gainesville, GA 30501

Reassigned Medicare billing, Georgia enrollment
1,172 clinicians in this Medicare group

NPI 1891745212 (770) 219-9000

Jefferson Hospital Association, Inc

461 mi

Family Medicine

1306 NORTH LINCOLN AVENUE
Star City, AR 71667

Reassigned Medicare billing, Arkansas enrollment
106 clinicians in this Medicare group

NPI 1568123982 (870) 628-1347

Core Physicians, LLC

917 mi

Family Medicine

4 ALUMNI DR
Exeter, NH 03833

Reassigned Medicare billing, New Hampshire enrollment
395 clinicians in this Medicare group

NPI 1336330588 (603) 580-6753

St Vincent Healthcare

1,480 mi

Family Medicine

16 N MILES AVE
Hardin, MT 59034

Reassigned Medicare billing, Montana enrollment
Medicare enrollment name: Scl Health Montana
186 clinicians in this Medicare group

NPI 1043266109 (406) 665-2205

Scl Health Medical Group - Billings, LLC

1,521 mi

General Practice

32 WICKS LN
Billings, MT 59105

Reassigned Medicare billing, Montana enrollment
438 clinicians in this Medicare group

NPI 1447866538 (406) 237-8400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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

Nerve conduction, 9-10 studies 95911

Nerve conduction studies involve sending small electrical shocks through the skin to measure how quickly nerves transmit signals. This helps detect nerve damage. 9-10 studies mean this process will be repeated on different nerves to gather comprehensive data.

59 services58 patients

Measurement of brain wave activity with video (veeg), 12-26 hours with review and report by health care professional 95720

This procedure monitors brain wave activity over 12-26 hours using Video EEG (VEEG). It involves recording brain waves and video to detect irregularities. A healthcare professional will review the data and provide a report. It's non-invasive and safe.

57 services35 patients

Nerve conduction, 5-6 studies 95909

Nerve conduction studies involve testing the speed and strength of signals traveling through your nerves. This helps identify any nerve damage or dysfunction. For 5-6 studies, this means multiple nerves will be tested. Small electrodes are placed on your skin to send and receive signals, causing minimal discomfort.

42 services42 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

34 services33 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

30 services30 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.

26 services21 patients

Nerve conduction, 7-8 studies 95910

Nerve conduction studies involve testing the speed and strength of signals traveling through your nerves. This helps doctors identify nerve damage. In a 7-8 study procedure, 7-8 specific nerves are tested. You may feel a mild, brief tingling or shock during the test.

24 services24 patients

Measurement of brain wave activity with video (veeg), 2-12 hours with review and report by health care professional 95718

This procedure, known as a Video EEG (VEEG), records brain wave activity for 2-12 hours. It involves attaching electrodes to your scalp and monitoring brain waves while a video records your actions. This helps health professionals understand and diagnose neurological issues.

12 services12 patients

Measurement of brain wave activity with video (veeg), 2-12 hours with review and report by health care professional 95718

11 services11 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

Quality

81.14

Promoting Interoperability

100

Improvement Activities

Cost

60.7

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.

LAURA J BANNER NP

Nurse Practitioner (Family)