PAVANKUMAR BOMMASAMUDRAM M.D.
NPI 1639306293
Internal Medicine in Tulsa, OK
About Pavankumar Bommasamudram M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PAVANKUMAR BOMMASAMUDRAM M.D. (NPI 1639306293) is an individual internal medicine provider in Tulsa, Oklahoma, licensed in Oklahoma (27309) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS, is affiliated with Methodist Jennie Edmundson, and is a graduate of Other (2008).
NPPES Registry Identity
Specialties & Licenses
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
Pavankumar Bommasamudram 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.
Medicare Billing Reassignments
20Medicare enrollment records show Pavankumar Bommasamudram reassigns Medicare billing to 20 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Tulsa, OK 74104
- Reassigned Medicare billing, Oklahoma enrollment
- 820 clinicians in this Medicare group
Tulsa, OK 74104
- Reassigned Medicare billing, Oklahoma enrollment
- 340 clinicians in this Medicare group
Claremore, OK 74017
- Reassigned Medicare billing, Texas enrollment
- 1,047 clinicians in this Medicare group
Muskogee, OK 74401
- Reassigned Medicare billing, Texas enrollment
- 655 clinicians in this Medicare group
Fairfax, OK 74637
- Reassigned Medicare billing, Oklahoma enrollment
- 55 clinicians in this Medicare group
Grove, OK 74344
- Reassigned Medicare billing, Oklahoma enrollment
- 95 clinicians in this Medicare group
Oklahoma City, OK 73106
- Reassigned Medicare billing, Oklahoma enrollment
- 63 clinicians in this Medicare group
Anadarko, OK 73005
- Reassigned Medicare billing, Oklahoma enrollment
- 55 clinicians in this Medicare group
El Dorado Springs, MO 64744
- Reassigned Medicare billing, Missouri enrollment
- Also billed through NPI 1720039605 (Missouri)
- 58 clinicians in this Medicare group
Superior, NE 68978
- Reassigned Medicare billing, Oklahoma enrollment
- 6 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 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.
Hospital Affiliations CMS Care Compare 5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Methodist Jennie Edmundson
Acute Care Hospitals · Council Bluffs, IASsm Health St Anthony Hospital - Oklahoma City
Acute Care Hospitals · Oklahoma City, OKCherokee Nation W W Hastings Indian Hospital
Acute Care Hospitals · Tahlequah, OKCouncil Oak Comprehensive Healthcare
Acute Care Hospitals · Tulsa, OKCreek Nation Community Hospital
Critical Access Hospitals · Okemah, OKPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 74104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
Referred Medical Equipment & Supplies CMS DME claims
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
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.
TULSA, OK 74104
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 Pavankumar Bommasamudram's NPI number?
The NPI number for Pavankumar Bommasamudram is 1639306293. It was assigned to this individual provider in the NPPES registry on June 22, 2009.
Where is Pavankumar Bommasamudram located?
Pavankumar Bommasamudram practices at 1705 E 19th St Ste #302, Tulsa, OK 74104. The listed phone number is (918) 748-7585.
What is Pavankumar Bommasamudram's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Pavankumar Bommasamudram enrolled in Medicare?
Yes. Pavankumar Bommasamudram 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 Pavankumar Bommasamudram's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Pavankumar Bommasamudram reassigns Medicare benefits to 20 organizations: St. John Physicians, Inc. (Tulsa, OK), Ahs Oklahoma Physician Group LLC (Tulsa, OK), Cherokee Nation (Claremore, OK), Creek Nation Hospital & Clinics (Muskogee, OK), Rural Wellness Fairfax Inc (Fairfax, OK) and 15 more organizations, listed in the Medicare section above. 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 Pavankumar Bommasamudram's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Pavankumar Bommasamudram accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter from Superior HealthPlan and 7 other insurers list Pavankumar Bommasamudram 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 Pavankumar Bommasamudram affiliated with any hospitals?
According to CMS data, Pavankumar Bommasamudram is affiliated with Methodist Jennie Edmundson, Ssm Health St Anthony Hospital - Oklahoma City, Cherokee Nation W W Hastings Indian Hospital, Council Oak Comprehensive Healthcare and Creek Nation Community Hospital.
When was this NPI record last updated?
The NPPES record for Pavankumar Bommasamudram was last updated on December 5, 2018. 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.
# Pavankumar Bommasamudram, M.D. · NPI 1639306293
Internal Medicine physician in Tulsa, Oklahoma. Individual provider, active in the CMS NPPES registry since June 22, 2009.
## Identity
- **NPI:** 1639306293 (Entity type: Individual)
- **Enumerated:** June 22, 2009
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** 27309 (Oklahoma)
- **Sole proprietor:** No
## Practice location
- **Address:** 1705 E 19TH ST, STE #302, Tulsa, OK 74104-5405
- **Phone:** (918) 748-7585 · **Fax:** (918) 748-7539
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 20 organizations under Medicare reassignment (form CMS-855R): St. John Physicians, Inc. (NPI 1336194406, Tulsa, OK); Ahs Oklahoma Physician Group LLC (NPI 1235182775, Tulsa, OK); Cherokee Nation (NPI 1497568968, Claremore, OK); Creek Nation Hospital & Clinics (NPI 1922873611, Muskogee, OK); Rural Wellness Fairfax Inc (NPI 1295362564, Fairfax, OK); and 15 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2008
## Record status
- **NPPES last updated:** December 5, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1639306293) · Data from the CMS NPPES public registry.