DR. PAVAN KUMAR MAMILLA M.D
NPI 1417188103
Family Medicine in Alpharetta, GA

Q: What is Pavan Kumar Mamilla's NPI number?

The NPI number for Pavan Kumar Mamilla is 1417188103. It was assigned to this individual provider in the NPPES registry on July 29, 2009.

Q: What is Pavan Kumar Mamilla's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since July 29, 2009PECOS EnrolledAccepts Medicare Assignment

11379 SOUTHBRIDGE PKWY STE A, ALPHARETTA, GA 30022(770) 777-0750(770) 777-0521 Get Directions Write a Review

NPPES record last updated: November 2, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Pavan Kumar Mamilla M.d NPPES

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

DR. PAVAN KUMAR MAMILLA M.D (NPI 1417188103) is an individual family medicine provider in Alpharetta, Georgia, licensed in Georgia (79227) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1417188103

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. PAVAN KUMAR MAMILLACredential: M.D

Location Address11379 SOUTHBRIDGE PKWY STE AAlpharetta, GA 30022-4402

Mailing Address11379 Southbridge Pkwy Ste AAlpharetta, GA 30022-4402 · (770) 777-0750 · Fax (770) 777-0521

Phone(770) 777-0750

Fax(770) 777-0521

Sole ProprietorNo

Medical School CMSOtherGraduated 2004

Enumeration DateJuly 29, 2009

Last NPPES UpdateNovember 2, 2023

NPPES CertifiedNovember 2, 2023

✔ NPI 1417188103 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in GA · 79227✔ Licensed in AL · MD.33421

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.

11379 SOUTHBRIDGE PKWY STE A, Alpharetta, GA 30022

Open in Google Maps ↗

Accepted Insurance

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

Dr. Pavan Kumar Mamilla 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 ID6103072962

PECOS Enrollment IDI20180523002377

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 13

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.

156 services63 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.

130 services58 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

120 services17 patients

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457

This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.

81 services12 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

73 services15 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

62 services56 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

36 services36 patients

Annual alcohol misuse screening, 5 to 15 minutes G0442

An annual alcohol misuse screening is a 15-minute check-up to assess your drinking habits. It helps identify if you're consuming alcohol in a way that could harm your health. This is not a judgment, but a tool to promote your wellbeing.

35 services35 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

29 services29 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

23 services23 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

21 services21 patients

Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected 0241U

This test detects the RNA of respiratory viruses, including COVID-19, Influenza A, Influenza B, and Respiratory Syncytial Virus, in an upper respiratory specimen. The test result will report if each virus is detected or not, helping in accurate diagnosis.

15 services12 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

15 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Northside Hospital

Acute Care Hospitals · Atlanta, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110161

Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County

Birthing friendly

Emory Johns Creek Hospital

Acute Care Hospitals · Johns Creek, GA

3/5 CMS rating

OwnershipProprietary

CMS Certification Number110230

Location6325 Hospital ParkwayJohns Creek, GA 30097 · Gwinnett County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30022 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

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

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.

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

95%248 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Leave this field empty

Other Providers at the Same Location NPPES 2

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

RAVALI REDDY KADARI MD

Family Medicine

11379 SOUTHBRIDGE PKWY STE A
ALPHARETTA, GA 30022

Fulton County (770) 777-0750

SWETHA ADDAGATLA

Family Medicine

11379 SOUTHBRIDGE PKWY STE A
ALPHARETTA, GA 30022

Fulton County (770) 777-0750

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 Kumar Mamilla's NPI number?

The NPI number for Pavan Kumar Mamilla is 1417188103. It was assigned to this individual provider in the NPPES registry on July 29, 2009.

Where is Pavan Kumar Mamilla located?

Pavan Kumar Mamilla practices at 11379 Southbridge Pkwy Ste A, Alpharetta, GA 30022. The listed phone number is (770) 777-0750.

What is Pavan Kumar Mamilla's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Pavan Kumar Mamilla enrolled in Medicare?

Yes. Pavan Kumar Mamilla 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 Kumar Mamilla accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Pavan Kumar Mamilla 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 Kumar Mamilla affiliated with any hospitals?

According to CMS data, Pavan Kumar Mamilla is affiliated with Northside Hospital and Emory Johns Creek Hospital.

When was this NPI record last updated?

The NPPES record for Pavan Kumar Mamilla was last updated on November 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.