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SUSHMA MADALA
NPI 1437530003
Internal Medicine in Scranton, PA

Active since June 09, 2015PECOS EnrolledAccepts Medicare Assignment
56.06/100
CMS Quality Rating
501 MADISON AVENUE, SCRANTON, PA 18510(570) 343-2383 Get Directions Write a Review

NPPES record last updated: August 8, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Sushma Madala NPPES

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

SUSHMA MADALA (NPI 1437530003) is an individual internal medicine provider in Scranton, Pennsylvania, licensed in Virginia (0101263825) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS, is affiliated with Bon Secours St Marys Hospital, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1437530003
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameSUSHMA MADALA
Location Address501 MADISON AVENUEScranton, PA 18510
Mailing Address501 Madison AvenueScranton, PA 18510 · (570) 343-2383
Phone(570) 343-2383
Sole ProprietorYes
Medical School CMSOtherGraduated 2007
Enumeration DateJune 9, 2015
Last NPPES UpdateAugust 8, 2022
NPPES CertifiedAugust 8, 2022
✔ NPI 1437530003 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in VA · 0101263825✔ Licensed in PA · MT209306
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
501 MADISON AVENUE, Scranton, PA 18510
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Other Names 1

Former Name (1)Sushma Velchuri

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

Sushma Madala 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 ID7315240199
PECOS Enrollment IDI20190319002964
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

4

Medicare enrollment records show Sushma Madala reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Hospitalist Medicine Physicians Of Virginia LLC
203 mi
Internal Medicine
1840 AMHERST ST
Winchester, VA 22601
  • Reassigned Medicare billing, Virginia enrollment
  • 371 clinicians in this Medicare group
NPI 1770756991 (540) 536-4334
Hospitalist Medicine Physicians Of Fredericksburg, LLC
235 mi
Internal Medicine
1001 SAM PERRY BLVD
Fredericksburg, VA 22401
  • Reassigned Medicare billing, Virginia enrollment
  • 258 clinicians in this Medicare group
NPI 1447577572 (330) 493-4443
Hospitalist Medicine Physicians Of Virginia - Richmond, LLC
282 mi
Internal Medicine
5801 BREMO RD
Richmond, VA 23226
  • Reassigned Medicare billing, Virginia enrollment
  • 104 clinicians in this Medicare group
NPI 1699311324 (804) 285-2011
Vituity-Virginia Hospitalists PC
282 mi
Hospitalist
5801 BREMO RD
Richmond, VA 23226
  • Reassigned Medicare billing, Virginia enrollment
  • 172 clinicians in this Medicare group
NPI 1518611011 (804) 285-2011

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 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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
586 services237 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
218 services214 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.
140 services76 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
77 services41 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.
27 services27 patients

Hospital Affiliations CMS Care Compare

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

Bon Secours St Marys Hospital

Acute Care Hospitals · Richmond, VA
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number490059
Location5801 Bremo RdRichmond, VA 23226 · Richmond City County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18510 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

56.06/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality26.71
Improvement Activities40
Cost76.15

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.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
4 suppliers15 claims15 services$14.69 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
4 suppliers22 claims22 services$63.07 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 6

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

INDERJIT KAUR M.D.
Internal Medicine
501 MADISON AVENUE
SCRANTON, PA 18510
Lackawanna County (570) 343-2383
SHIRAZ SALEEM D.O.
Internal Medicine
501 MADISON AVENUE, THE WRIGHT CENTER
SCRANTON, PA 18510
Lackawanna County (570) 343-2383
STEVEN ARCHAMBAULT
Family Medicine
501 MADISON AVENUE
SCRANTON, PA 18510
Lackawanna County (570) 343-2383
DR. ZOYA JAHANZEB EFFENDI M.D.
Internal Medicine
501 MADISON AVENUE
SCRANTON, PA 18510
Lackawanna County (570) 343-2383
MR. MASATO SUGIURA DO
Student in an Organized Health Care Education/Training Program
501 MADISON AVENUE, TOBIN HALL
SCRANTON, PA 18510
Lackawanna County (570) 343-2383
MRS. PRASANTHI LIMGALA M.D
Student in an Organized Health Care Education/Training Program
501 MADISON AVENUE
SCRANTON, PA 18510
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 Sushma Madala's NPI number?

The NPI number for Sushma Madala is 1437530003. It was assigned to this individual provider in the NPPES registry on June 9, 2015. The provider is also known as Sushma Velchuri.

Where is Sushma Madala located?

Sushma Madala practices at 501 Madison Avenue, Scranton, PA 18510. The listed phone number is (570) 343-2383.

What is Sushma Madala's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Sushma Madala enrolled in Medicare?

Yes. Sushma Madala 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.

Which organizations bill Medicare for Sushma Madala's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sushma Madala reassigns Medicare benefits to 4 organizations: Hospitalist Medicine Physicians Of Virginia LLC (Winchester, VA), Hospitalist Medicine Physicians Of Fredericksburg, LLC (Fredericksburg, VA), Hospitalist Medicine Physicians Of Virginia - Richmond, LLC (Richmond, VA) and Vituity-Virginia Hospitalists PC (Richmond, VA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sushma Madala's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Sushma Madala affiliated with any hospitals?

According to CMS data, Sushma Madala is affiliated with Bon Secours St Marys Hospital.

When was this NPI record last updated?

The NPPES record for Sushma Madala was last updated on August 8, 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.