DR. PRATHYUSHA MADDELA M.D.
NPI 1437174448
Internal Medicine - Nephrology in Anniston, AL

Q: What is Prathyusha Maddela's NPI number?

The NPI number for Prathyusha Maddela is 1437174448. It was assigned to this individual provider in the NPPES registry on July 12, 2006.

Q: What is Prathyusha Maddela's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Active since July 12, 2006PECOS EnrolledAccepts Medicare Assignment

83.73/100

CMS Quality Rating

522 E 11TH ST STE 200, ANNISTON, AL 36207(256) 237-5302(256) 237-5368 Get Directions Write a Review

NPPES record last updated: August 21, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 21, 2020, Sep 19, 2016 (2 updates tracked since 2016).

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About Dr. Prathyusha Maddela M.d. NPPES

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

DR. PRATHYUSHA MADDELA M.D. (NPI 1437174448) is an individual nephrology provider in Anniston, Alabama, licensed in Alabama (26169) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1999).

NPPES Registry Identity

NPI1437174448

Entity TypeIndividualFemale

Primary Taxonomy207RN0300X

Provider Legal NameDR. PRATHYUSHA MADDELACredential: M.D.

Location Address522 E 11TH ST STE 200Anniston, AL 36207-4770

Mailing Address522 E 11th St, Suite 200Anniston, AL 36207-4770 · (256) 237-5302 · Fax (256) 237-5368

Phone(256) 237-5302

Fax(256) 237-5368

Sole ProprietorNo

Medical School CMSOtherGraduated 1999

Enumeration DateJuly 12, 2006

Last NPPES UpdateAugust 21, 20202 updates tracked since enumeration

NPPES CertifiedAugust 21, 2020

✔ NPI 1437174448 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in AL · 26169

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

522 E 11TH ST STE 200, Anniston, AL 36207

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Other Identifiers 1

Medicaid9937848AL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Magnolia Health, 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. Prathyusha Maddela 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 ID8224034426

PECOS Enrollment IDI20061011000491

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.

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.

602 services179 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.

467 services334 patients

Hemodialysis procedure with physician evaluation 90935

Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.

223 services49 patients

Dialysis services, 4 or more physician visits per month (20 years or older) 90960

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.

222 services68 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

205 services103 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

150 services131 patients

Home dialysis services per month (20 years or older) 90966

Home dialysis services provide kidney treatment for patients aged 20 or older right in their own homes. This service includes necessary equipment, supplies, and support for performing dialysis. It's a convenient option that allows patients to maintain their daily routines while receiving essential care.

103 services15 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.

101 services71 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.

73 services73 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

69 services69 patients

Creatinine level to test for kidney function or muscle injury 82570

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

69 services69 patients

Dialysis services, 2-3 physician visits per month (20 years or older) 90961

Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.

16 services14 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36207 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

$122.31 typical visit price

range $52.65 – $161.63

Typical copayment $30.57 (range $13.16 – $40.40)

Most-billed visit code 99204

Established Patient

$93.72 typical visit price

range $16.56 – $131.65

Typical copayment $23.43 (range $4.14 – $32.91)

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.

83.73/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

68.28

Promoting Interoperability

100

Cost

68.57

Reported Quality Measures

Controlling High Blood Pressure

64%679 patients3/55-star benchmark: 91%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

76%347 patients2/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

99%1,930 patients4/55-star benchmark: 100%

e-Prescribing

99%1,462 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

0%786 patients1/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

21%1,098 patients1/55-star benchmark: 98%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 99% · 644 patients

Patients screened: 100% · 644 patients

98%82 patients4/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

100%1,101 patients5/55-star benchmark: 100%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 818 patients

Patients totalRate: 0% · 818 patients

0%818 patients5/55-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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Cyclosporine, oral, 100 mg J7502

Treatment-Treatment - Miscellaneous · category RX029N

1 supplier13 claims780 services$1.68 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511

Treatment-Chemotherapy · category RH012N

1 supplier12 claims12 services$18.96 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

MS. ASHLEY BAIN WILLIAMSON NP

Nurse Practitioner (Acute Care)

522 E 11TH ST STE 200
ANNISTON, AL 36207

Calhoun County (256) 237-5302

NAVEEN KUMAR BADE M.D

Internal Medicine (Nephrology)

522 E 11TH ST STE 200
ANNISTON, AL 36207

Calhoun County (256) 237-5302

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 Prathyusha Maddela's NPI number?

The NPI number for Prathyusha Maddela is 1437174448. It was assigned to this individual provider in the NPPES registry on July 12, 2006.

Where is Prathyusha Maddela located?

Prathyusha Maddela practices at 522 E 11th St Ste 200, Anniston, AL 36207. The listed phone number is (256) 237-5302.

What is Prathyusha Maddela's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Prathyusha Maddela enrolled in Medicare?

Yes. Prathyusha Maddela 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 Prathyusha Maddela accept?

Health plans from Ambetter Health, Ambetter from Magnolia Health, Ambetter of Alabama, Ambetter of Tennessee and Blue Cross and Blue Shield of Alabama and 1 other insurer list Prathyusha Maddela 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.

When was this NPI record last updated?

The NPPES record for Prathyusha Maddela was last updated on August 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.