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SUPRIYA IMMANENI MD
NPI 1497129399
Dermatology - MOHS-Micrographic Surgery in Macon, GA

Active since November 17, 2015PECOS EnrolledAccepts Medicare Assignment
70.15/100
CMS Quality Rating
308 COLISEUM DR, ST 200, MACON, GA 31217(478) 742-2180 Get Directions Write a Review

NPPES record last updated: January 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 13, 2026, Jan 2, 2024, Nov 19, 2015 (3 updates tracked since 2015).

About Supriya Immaneni Md NPPES

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

SUPRIYA IMMANENI MD (NPI 1497129399) is an individual mohs-micrographic surgery provider in Macon, Georgia, licensed in Georgia (95284) and active in the NPI registry since November 2015. She is enrolled in Medicare PECOS and is a graduate of Northwestern University Feinberg Medical School (2019).

NPPES Registry Identity

NPI1497129399
Entity TypeIndividualFemale
Primary Taxonomy207ND0101X
Provider Legal NameSUPRIYA IMMANENICredential: MD
Location Address308 COLISEUM DR, ST 200Macon, GA 31217-3865
Mailing Address308 Coliseum Dr, St 200Macon, GA 31217-3865 · (478) 742-2180
Phone(478) 742-2180
Sole ProprietorNo
Medical School CMSNorthwestern University Feinberg Medical SchoolGraduated 2019
Enumeration DateNovember 17, 2015
Last NPPES UpdateJanuary 13, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 13, 2026
✔ NPI 1497129399 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
License✔ Licensed in GA · 95284
Definition
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Also ListedDermatologyTaxonomy 207N00000X · License 95284 (GA)
308 COLISEUM DR, Macon, GA 31217
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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

Supriya Immaneni Md 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 ID3274959556
PECOS Enrollment IDI20230713000227
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 9

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.

Destruction of precancer skin growth, 2-14 growths 17003
This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
529 services90 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.
175 services152 patients
Destruction of precancer skin growth, 1 growth 17000
"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.
138 services123 patients
Biopsy of related skin growth, first growth 11102
A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.
82 services79 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
57 services46 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
44 services44 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31217 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
Most-billed visit code 99213
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.

70.15/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality83.67
Promoting Interoperability100
Improvement Activities40
Cost16.83

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.

CASSANDRA MICHEL FLOYD PHARMD
Pharmacist
308 COLISEUM DR, SUITE 150
MACON, GA 31217
Bibb County (478) 741-8599
DAVID E KENT MD
Dermatology (MOHS-Micrographic Surgery)
308 COLISEUM DR, SUITE 200
MACON, GA 31217
Bibb County (478) 742-2180
MR. JOHNATHAN PHILLIP HARKINS PA-C
Physician Assistant
308 COLISEUM DR
MACON, GA 31217
Bibb County (478) 742-2180
DR. PREMILA MALHOTRA MD
Internal Medicine (Hematology & Oncology)
308 COLISEUM DR, SUITE 120
MACON, GA 31217
Bibb County (478) 745-6130
NORTHSIDE HOSPITAL, INC.
Pharmacy (Community/Retail Pharmacy)
308 COLISEUM DR
MACON, GA 31217
Bibb County (478) 741-8599
MR. JEFFREY ALAN HARRIS MSN
Nurse Practitioner
308 COLISEUM DR, SUITE 120
MACON, GA 31217
Bibb County (478) 745-6130
CAITLIN ELIZABETH EILERS PA-C
Physician Assistant
308 COLISEUM DR, SUITE 200
MACON, GA 31217
Bibb County (478) 742-2180
MS. LAURIE G. JOHNSON MSN
Nurse Practitioner
308 COLISEUM DR, SUITE 120
MACON, GA 31217
Bibb County (770) 496-9400

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 Supriya Immaneni's NPI number?

The NPI number for Supriya Immaneni is 1497129399. It was assigned to this individual provider in the NPPES registry on November 17, 2015.

Where is Supriya Immaneni located?

Supriya Immaneni practices at 308 Coliseum Dr St 200, Macon, GA 31217. The listed phone number is (478) 742-2180.

What is Supriya Immaneni's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Is Supriya Immaneni enrolled in Medicare?

Yes. Supriya Immaneni 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.

When was this NPI record last updated?

The NPPES record for Supriya Immaneni was last updated on January 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.