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PAVANKUMAR BOMMASAMUDRAM M.D.
NPI 1639306293
Internal Medicine in Tulsa, OK

Active since June 22, 2009PECOS EnrolledAccepts Medicare Assignment
85.83/100
CMS Quality Rating
1705 E 19TH ST, STE #302, TULSA, OK 74104(918) 748-7585(918) 748-7539 Get Directions Write a Review

NPPES record last updated: December 5, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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

NPI1639306293
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NamePAVANKUMAR BOMMASAMUDRAMCredential: M.D.
Location Address1705 E 19TH ST, STE #302Tulsa, OK 74104-5405
Mailing Address1705 E 19th St, Ste #302Tulsa, OK 74104 · (918) 748-7585 · Fax (918) 748-7539
Phone(918) 748-7585
Fax(918) 748-7539
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateJune 22, 2009
Last NPPES UpdateDecember 5, 2018
✔ NPI 1639306293 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in OK · 27309✔ Licensed in KS · 04-41542
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.
1705 E 19TH ST, Tulsa, OK 74104
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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 from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

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

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.

PECOS PAC ID3779749478
PECOS Enrollment IDI20120725000093, I20190617000508, I20210405000178, I20230622001945, I20240914000436
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.

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.
116 services79 patients
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.
110 services69 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
108 services85 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.
71 services70 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
40 services27 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.
23 services23 patients

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, IA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number160047
Location933 East Pierce StreetCouncil Bluffs, IA 51503 · Pottawattamie County
Emergency services Birthing friendly

Ssm Health St Anthony Hospital - Oklahoma City

Acute Care Hospitals · Oklahoma City, OK
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number370037
Location1000 North Lee AvenueOklahoma City, OK 73101 · Oklahoma County
Emergency services Birthing friendly

Cherokee Nation W W Hastings Indian Hospital

Acute Care Hospitals · Tahlequah, OK
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number370171
Location100 S Bliss AvenueTahlequah, OK 74464 · Cherokee County
Emergency services Birthing friendly

Council Oak Comprehensive Healthcare

Acute Care Hospitals · Tulsa, OK
OwnershipTribal
CMS Certification Number370244
Location10109 E 79th StTulsa, OK 74133 · Tulsa County

Creek Nation Community Hospital

Critical Access Hospitals · Okemah, OK
OwnershipTribal
CMS Certification Number371333
Location1800 E CoplinOkemah, OK 74859 · Okfuskee County
Emergency services

Physician 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.

New Patient
$123.06 typical visit price
range $53.00 – $162.61
Typical copayment $30.76 (range $13.25 – $40.65)
Most-billed visit code 99204
Established Patient
$94.27 typical visit price
range $16.68 – $132.40
Typical copayment $23.56 (range $4.17 – $33.10)
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.

85.83/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality90.74
Promoting Interoperability100
Improvement Activities40
Cost51.95

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.

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
2 suppliers44 claims44 services$913.24 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.

TERESSA HEADRICK LEMASTER CNS
Clinical Nurse Specialist (Acute Care)
1705 E 19TH ST, SUITE 302
TULSA, OK 74104
Tulsa County (918) 748-7585
ERIN MATHEWS CAPPS PA
Physician Assistant
1705 E 19TH ST, SUITE 302
TULSA, OK 74104
Tulsa County (918) 748-7585
KRISTY LEE SUNDENE M.D.
Internal Medicine
1705 E 19TH ST, STE 302
TULSA, OK 74104
Tulsa County (918) 748-7585
HUY QUOC LUU D.O.
Family Medicine
1705 E 19TH ST, SUITE 302
TULSA, OK 74104
Tulsa County (918) 748-7585
STEPHEN ANDREW JENKS PA
Physician Assistant
1705 E 19TH ST, SUITE 302
TULSA, OK 74104
Tulsa County (918) 748-7585
SHANNON PARKER NP
Nurse Practitioner
1705 E 19TH ST, STE 302
TULSA, OK 74104
Tulsa County (918) 748-7585
MARK A KELLEY MD
Psychiatry & Neurology (Psychiatry)
1705 E 19TH ST, 512
TULSA, OK 74104
Tulsa County (918) 747-6095
KAYLYNN COATS ELMORE PA
Physician Assistant
1705 E 19TH ST, SUITE 302
TULSA, OK 74104
Tulsa County (918) 748-7585

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.

What insurance does Pavankumar Bommasamudram accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma 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.