DR. UMASHANKAR K BALLEHANINNA M.D
NPI 1578721767
Surgery - Vascular Surgery in Sayre, PA

Q: What is Umashankar Ballehaninna's NPI number?

The NPI number for Umashankar Ballehaninna is 1578721767. It was assigned to this individual provider in the NPPES registry on May 25, 2008.

Q: What is Umashankar Ballehaninna's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Active since May 25, 2008PECOS EnrolledAccepts Medicare Assignment

82.9/100

CMS Quality Rating

1 GUTHRIE SQ, SAYRE, PA 18840(570) 887-2848 Get Directions Write a Review

NPPES record last updated: March 4, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Mar 4, 2021, Nov 3, 2016, Jun 27, 2016 (3 updates tracked since 2016).

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About Dr. Umashankar K Ballehaninna M.d NPPES

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

DR. UMASHANKAR K BALLEHANINNA M.D (NPI 1578721767) is an individual vascular surgery provider in Sayre, Pennsylvania, licensed in Pennsylvania (MD458572) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS, is affiliated with Middlesboro Arh Hospital, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1578721767

Entity TypeIndividualMale

Primary Taxonomy2086S0129X

Provider Legal NameDR. UMASHANKAR K BALLEHANINNACredential: M.D

Location Address1 GUTHRIE SQSayre, PA 18840-1625

Mailing Address1 Guthrie SqSayre, PA 18840-1625 · (570) 888-5858

Phone(570) 887-2848

Sole ProprietorYes

Medical School CMSOtherGraduated 2003

Enumeration DateMay 25, 2008

Last NPPES UpdateMarch 4, 20213 updates tracked since enumeration

NPPES CertifiedMarch 4, 2021

✔ NPI 1578721767 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Vascular SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0129X

License✔ Licensed in PA · MD458572

Definition

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1 GUTHRIE SQ, Sayre, PA 18840

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter Health, Ambetter of Alabama and more.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. Umashankar K Ballehaninna 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 ID2365760972

PECOS Enrollment IDI20240208002908

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

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

Guthrie Medical Group, P.C.

4.1 mi

Family Medicine

412 S MAIN ST
Athens, PA 18810

Reassigned Medicare billing, Pennsylvania and New York enrollments
Medicare enrollment name: Guthrie Medical Group PC
Also billed through NPI 1245246644 (New York)
830 clinicians in this Medicare group

NPI 1962451153 (570) 888-9655

Innovative Vascular, PLLC

592 mi

Vascular Surgery

460 MEDICAL PARK DR STE 104
Lenoir City, TN 37772

Reassigned Medicare billing, Tennessee enrollment
3 clinicians in this Medicare group

NPI 1124750765 (865) 562-3232

Apex Vascular Outpatient Center

592 mi

Ambulatory Surgical

460 MEDICAL PARK DR STE 105
Lenoir City, TN 37772

Reassigned Medicare billing, Tennessee enrollment
3 clinicians in this Medicare group

NPI 1467216457 (865) 562-3232

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 16

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.

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.

69 services69 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.

44 services40 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.

38 services33 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.

31 services29 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.

26 services26 patients

Ultrasound study of one arm or leg veins with compression and maneuvers 93971

This is a non-invasive procedure using sound waves to visualize veins in an arm or leg. It involves applying gentle pressure and performing certain movements. It helps identify any abnormal blood flow or clots, ensuring vascular health.

23 services23 patients

Ultrasound study of one arm or leg veins with compression and maneuvers 93971

21 services20 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.

21 services13 patients

Ultrasound of both sides of head and neck blood flow 93880

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

19 services19 patients

Ultrasound study of arm or leg veins with compression and maneuvers 93970

An ultrasound study of arm or leg veins with compression and maneuvers is a non-invasive procedure that uses sound waves to create images of your veins. This helps identify blood clots or other vein problems. During the procedure, pressure is applied to the veins and certain movements are performed to assess blood flow.

17 services16 patients

Ultrasonic guidance for blood vessel access 76937

Ultrasonic guidance for blood vessel access is a medical procedure where sound waves are used to create images of your blood vessels. This helps doctors to accurately locate and access the vessels for treatments or tests, ensuring safety and precision.

14 services14 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

14 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.

14 services14 patients

Complete ultrasound study of arm and leg arteries 93923

This procedure involves using sound waves to produce images of your arm and leg arteries. It helps identify blockages or abnormalities that could lead to conditions like stroke or peripheral artery disease. It's non-invasive and painless.

13 services13 patients

Ultrasound of hemodialysis access 93990

An ultrasound of hemodialysis access is a non-invasive procedure that uses sound waves to create images of your dialysis access site. It helps monitor the access site's health and detect any potential issues like blockages or narrowing.

13 services12 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Middlesboro Arh Hospital

Acute Care Hospitals · Middlesboro, KY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180020

Location3600 West Cumberland AvenueMiddlesboro, KY 40965 · Bell County

Emergency services Birthing friendly

University Health System, Inc

Acute Care Hospitals · Knoxville, TN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440015

Location1924 Alcoa HighwayKnoxville, TN 37920 · Knox County

Emergency services Birthing friendly

Claiborne Medical Center

Acute Care Hospitals · Tazewell, TN

OwnershipGovernment - Local

CMS Certification Number440057

Location1850 Old Knoxville HighwayTazewell, TN 37879 · Claiborne County

Emergency services

Fort Loudoun Medical Center

Acute Care Hospitals · Lenoir City, TN

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number440110

Location550 Fort Loudon Medical Center DrLenoir City, TN 37772 · Loudon County

Emergency services

Physicians Regional Medical Center

Acute Care Hospitals · Powell, TN

2/5 CMS rating

OwnershipProprietary

CMS Certification Number440120

Location7565 Dannaher Way PowellPowell, TN 37849 · Knox County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18840 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

$84.88 typical visit price

range $54.64 – $166.87

Typical copayment $21.22 (range $13.66 – $41.71)

Most-billed visit code 99203

Established Patient

$68.36 typical visit price

range $17.33 – $135.84

Typical copayment $17.09 (range $4.33 – $33.96)

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.

82.9/100

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

Scored as part of a group practice

Quality

74.09

Promoting Interoperability

100

Improvement Activities

Cost

65.94

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.

DR. PHILLIP LUNSFORD MD

Emergency Medicine

1 GUTHRIE SQ
SAYRE, PA 18840

Bradford County (570) 888-5858

MRS. MELISSA FOX OTR/L

Occupational Therapist

1 GUTHRIE SQ
SAYRE, PA 18840

Bradford County (570) 887-4801

DR. PREMJEET SINGH DHILLON MD

Internal Medicine

1 GUTHRIE SQ
SAYRE, PA 18840

Bradford County (570) 888-6666

WILLIAM HUNTER EDWARDS

Student in an Organized Health Care Education/Training Program

1 GUTHRIE SQ
SAYRE, PA 18840

Bradford County (570) 888-6666

DONNA L TAMKIN MD

Radiology (Diagnostic Radiology)

1 GUTHRIE SQ
SAYRE, PA 18840

Bradford County (570) 888-5858

DR. BRUCE C SLAGLE M.D.

Hospitalist

1 GUTHRIE SQ
SAYRE, PA 18840

Bradford County (570) 888-5858

MS. EMILY S. OBERST PA-C

Physician Assistant

1 GUTHRIE SQ
SAYRE, PA 18840

Bradford County (570) 888-5858

GUTHRIE MEDICAL GROUP PC

Physical Medicine & Rehabilitation (Pain Medicine)

1 GUTHRIE SQ
SAYRE, PA 18840

Bradford County (570) 887-2201

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 Umashankar Ballehaninna's NPI number?

The NPI number for Umashankar Ballehaninna is 1578721767. It was assigned to this individual provider in the NPPES registry on May 25, 2008.

Where is Umashankar Ballehaninna located?

Umashankar Ballehaninna practices at 1 Guthrie Sq, Sayre, PA 18840. The listed phone number is (570) 887-2848.

What is Umashankar Ballehaninna's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Is Umashankar Ballehaninna enrolled in Medicare?

Yes. Umashankar Ballehaninna 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 Umashankar Ballehaninna's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Umashankar Ballehaninna reassigns Medicare benefits to 3 organizations: Guthrie Medical Group, P.C. (Athens, PA), Innovative Vascular, PLLC (Lenoir City, TN) and Apex Vascular Outpatient Center (Lenoir City, TN). 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 Umashankar Ballehaninna's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Umashankar Ballehaninna accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Umashankar Ballehaninna 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 Umashankar Ballehaninna affiliated with any hospitals?

According to CMS data, Umashankar Ballehaninna is affiliated with Middlesboro Arh Hospital, University Health System, Inc, Claiborne Medical Center, Fort Loudoun Medical Center and Physicians Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Umashankar Ballehaninna was last updated on March 4, 2021. 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.