DR. NAVEEN KUMAR GUMMADI M.D
NPI 1558711606
Internal Medicine in Youngstown, OH

Q: What is Naveen Gummadi's NPI number?

The NPI number for Naveen Gummadi is 1558711606. It was assigned to this individual provider in the NPPES registry on June 20, 2016.

Q: What is Naveen Gummadi's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Naveen Gummadi was last updated on July 2, 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.

Active since June 20, 2016PECOS EnrolledAccepts Medicare Assignment

500 GYPSY LANE, YOUNGSTOWN, OH 44501(330) 884-4250(330) 884-0651 Get Directions Write a Review

NPPES record last updated: July 2, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 2, 2019, Mar 15, 2017, Jun 20, 2016 (3 updates tracked since 2016).

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About Dr. Naveen Kumar Gummadi M.d NPPES

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

DR. NAVEEN KUMAR GUMMADI M.D (NPI 1558711606) is an individual internal medicine provider in Youngstown, Ohio, licensed in New Mexico (MD2018-0819) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS, is affiliated with Presbyterian Hospital, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1558711606

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. NAVEEN KUMAR GUMMADICredential: M.D

Location Address500 GYPSY LANEYoungstown, OH 44501

Mailing Address500 Gypsy LaneYoungstown, OH 44501 · (330) 884-4250 · Fax (330) 884-0651

Phone(330) 884-4250

Fax(330) 884-0651

Sole ProprietorYes

Medical School CMSOtherGraduated 2006

Enumeration DateJune 20, 2016

Last NPPES UpdateJuly 2, 20193 updates tracked since enumeration

✔ NPI 1558711606 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in NM · MD2018-0819

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.

500 GYPSY LANE, Youngstown, OH 44501

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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

Dr. Naveen Kumar Gummadi 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 ID1355677386

PECOS Enrollment IDI20190729000776

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 12

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.

273 services108 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.

188 services182 patients

Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310

A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.

140 services51 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

92 services46 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.

87 services85 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.

73 services38 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

39 services37 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

32 services28 patients

Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310

32 services22 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

17 services16 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

17 services17 patients

Advance care planning, first 30 minutes 99497

17 services16 patients

Hospital Affiliations CMS Care Compare

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

Presbyterian Hospital

Acute Care Hospitals · Albuquerque, NM

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number320021

Location1100 Central Avenue SEAlbuquerque, NM 87106 · Bernalillo County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44501 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

$126.12 typical visit price

range $54.34 – $166.65

Typical copayment $31.53 (range $13.58 – $41.66)

Most-billed visit code 99204

Established Patient

$96.44 typical visit price

range $17.10 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

97%291 patients4/55-star benchmark: 99%

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 3

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

5 suppliers68 claims71 services$18.46 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

1 supplier12 claims12 services$873.79 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

5 suppliers88 claims91 services$72.46 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 10

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

MR. PHILIP B HOWREN DO

Emergency Medicine