DR. USHA G NAYAK MD,ABSM
NPI 1548222474
Internal Medicine - Critical Care Medicine in Gainesville, GA

Active since April 05, 2006PECOS EnrolledAccepts Medicare Assignment
71.14/100
CMS Quality Rating
743 SPRING ST NE, GAINESVILLE, GA 30501(770) 219-9000 Get Directions Write a Review

NPPES record last updated: April 12, 2019. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Apr 12, 2019, Feb 2, 2017 (2 updates tracked since 2017).

About Dr. Usha G Nayak Md,absm NPPES

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

DR. USHA G NAYAK MD,ABSM (NPI 1548222474) is an individual critical care medicine provider in Gainesville, Georgia, licensed in Georgia (053006) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and maintains a secondary practice location in Cumming.

NPPES Registry Identity

NPI1548222474
Entity TypeIndividualFemale
Primary Taxonomy207RC0200X
Provider Legal NameDR. USHA G NAYAKCredential: MD,ABSM
Location Address743 SPRING ST NEGainesville, GA 30501
Mailing AddressPo Box 742616Atlanta, GA 30374-2616 · (770) 219-8420 · Fax (770) 219-8440
Sole ProprietorYes
Medical School CMSOtherGraduated 1993
Enumeration DateApril 5, 2006
Last NPPES UpdateApril 12, 20192 updates tracked since enumeration
✔ NPI 1548222474 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RC0200X
License✔ Licensed in GA · 053006
Definition
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Also ListedInternal MedicineTaxonomy 207R00000X · License 053006 (GA)
Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License 053006 (GA)
Also ListedInternal Medicine · Sleep MedicineTaxonomy 207RS0012X · License 053006 (GA)
743 SPRING ST NE, Gainesville, GA 30501

Secondary Practice Location 1

Location 11400 Northside Forsyth Dr, Suite 210Cumming, GA 30041-7668 · Phone (678) 288-5864 · Fax (678) 455-0010

Other Identifiers 4

Medicaid710561989FGA
Medicaid710561989GGA
Medicaid710561989AGA
Medicaid710561989HGA

Accepted 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

Dr. Usha G Nayak Md,absm 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 ID4385618792
PECOS Enrollment IDI20040823000394
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

3

Medicare enrollment records show Usha Nayak reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Family Medicine
743 SPRING ST NE
Gainesville, GA 30501
  • Reassigned Medicare billing, Georgia enrollment
  • 1,172 clinicians in this Medicare group
Urgent Care
81 NORTHSIDE DAWSON DRIVE
Dawsonville, GA 30534
  • Reassigned Medicare billing, Georgia enrollment
  • 466 clinicians in this Medicare group
Family Medicine
11685 ALPHARETTA HWY, SUITE 300
Roswell, GA 30076
  • Reassigned Medicare billing, Georgia enrollment
  • 3,885 clinicians in this Medicare group

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 24

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.
925 services466 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.
594 services226 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.
507 services349 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
158 services155 patients
Test to determine lung volumes using sensors 94726
This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.
157 services154 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.
141 services134 patients

Hospital Affiliations CMS Care Compare 4

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

Northside Hospital Forsyth

Acute Care Hospitals · Cumming, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110005
Location1200 Northside Forsyth DriveCumming, GA 30041 · Forsyth County
Birthing friendly

Northside Hospital Cherokee

Acute Care Hospitals · Canton, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110008
Location450 Northside Cherokee BoulevardCanton, GA 30115 · Cherokee County
Emergency services Birthing friendly

Northside Hospital Gwinnett

Acute Care Hospitals · Lawrenceville, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110087
Location1000 Medical Center BoulevardLawrenceville, GA 30046 · Gwinnett County
Birthing friendly

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

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.

71.14/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality68.76
Improvement Activities40
Cost53.17

Reported Quality Measures

Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse)
Lower rates are better for this measure.
79%33 patients1/55-star benchmark: 100%
Advance Care Plan
1%1,388 patients1/55-star benchmark: 100%
Closing the Referral Loop: Receipt of Specialist Report
11%133 patients1/55-star benchmark: 87%
Colorectal Cancer Screening
1%1,544 patients1/55-star benchmark: 88%
Controlling High Blood Pressure
66%1,009 patients3/55-star benchmark: 91%
Diabetes: Eye Exam
0%329 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
99%329 patients1/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
100%5,138 patients5/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
0%1,350 patients1/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
57%2,260 patients3/55-star benchmark: 98%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
34%2,231 patients3/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 95% · 1,517 patients
Patients screened: 100% · 1,517 patients
49%143 patients2/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
75%873 patients3/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 1,389 patients
Patients totalRate: 10% · 1,400 patients
10%1,400 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.

Referred Medical Equipment & Supplies CMS DME claims 34

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
24 suppliers461 claims461 services$33.62 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
9 suppliers97 claims196 services$1.33 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable A7005
DME-Other DME · category DE000N
4 suppliers36 claims36 services$9.55 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
19 suppliers320 claims320 services$75.46 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
19 suppliers309 claims903 services$29.12 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
19 suppliers249 claims1,431 services$15.97 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 20

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

Nurse Anesthetist, Certified Registered
743 SPRING ST NE
GAINESVILLE, GA 30501
Emergency Medicine
743 SPRING ST NE
GAINESVILLE, GA 30501
Nurse Practitioner (Gerontology)
743 SPRING ST NE
GAINESVILLE, GA 30501
Emergency Medicine
743 SPRING ST NE
GAINESVILLE, GA 30501
Physician Assistant (Surgical)
743 SPRING ST NE
GAINESVILLE, GA 30501
Pharmacist
743 SPRING ST NE
GAINESVILLE, GA 30501
Anesthesiologist Assistant
743 SPRING ST NE
GAINESVILLE, GA 30501
Emergency Medicine
743 SPRING ST NE
GAINESVILLE, GA 30501

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 Usha Nayak's NPI number?

The NPI number for Usha Nayak is 1548222474. It was assigned to this individual provider in the NPPES registry on April 5, 2006.

Where is Usha Nayak located?

Usha Nayak practices at 743 Spring St NE, Gainesville, GA 30501. The listed phone number is (770) 219-9000.

What is Usha Nayak's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Is Usha Nayak enrolled in Medicare?

Yes. Usha Nayak 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 Usha Nayak's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Usha Nayak reassigns Medicare benefits to 3 organizations: Northeast Georgia Physicians Group Inc (Gainesville, GA), Northside Primary Care Professional Services, LLC (Dawsonville, GA) and Wellstar Medical Group, LLC (Roswell, GA). 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 Usha Nayak's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Usha Nayak 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 Usha Nayak 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 Usha Nayak affiliated with any hospitals?

According to CMS data, Usha Nayak is affiliated with Northside Hospital Forsyth, Northside Hospital Cherokee, Northside Hospital Gwinnett and Northside Hospital.

When was this NPI record last updated?

The NPPES record for Usha Nayak was last updated on April 12, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.