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DR. GUSTAVO PRADILLA M.D.
NPI 1659425916
Neurological Surgery in Baltimore, MD

Active since January 23, 2007PECOS EnrolledAccepts Medicare Assignment
94.56/100
CMS Quality Rating
600 N WOLFE ST, MEYER 8-161, BALTIMORE, MD 21287(410) 955-6405 Get Directions Write a Review

NPPES record last updated: July 15, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 15, 2026, Nov 27, 2017 (2 updates tracked since 2017).

About Dr. Gustavo Pradilla M.d. NPPES

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

DR. GUSTAVO PRADILLA M.D. (NPI 1659425916) is an individual neurological surgery provider in Baltimore, Maryland, licensed in Georgia (070411) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, is affiliated with Emory University Hospital, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1659425916
Entity TypeIndividualMale
Primary Taxonomy207T00000X
Provider Legal NameDR. GUSTAVO PRADILLACredential: M.D.
Location Address600 N WOLFE ST, MEYER 8-161Baltimore, MD 21287-0005
Mailing Address2318 Bright Leaf WayBaltimore, MD 21209-3470 · (410) 358-3432
Phone(410) 955-6405
Sole ProprietorYes
Medical School CMSOtherGraduated 2002
Enumeration DateJanuary 23, 2007
Last NPPES UpdateJuly 15, 20262 updates tracked since enumeration
NPPES CertifiedJuly 15, 2026
✔ NPI 1659425916 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNeurological SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207T00000X
Licenses✔ Licensed in GA · 070411✔ Licensed in MD · P20471
Definition
A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.
600 N WOLFE ST, Baltimore, MD 21287
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, 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. Gustavo Pradilla 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 ID4284878232
PECOS Enrollment IDI20130913000367
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

2

Medicare enrollment records show Gustavo Pradilla reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The Emory Clinic Inc
573 mi
Internal Medicine
1365 CLIFTON RD NE
Atlanta, GA 30322
  • Reassigned Medicare billing, Georgia enrollment
  • 4,840 clinicians in this Medicare group
NPI 1396798229 (404) 778-2144
Emory Medical Care Foundation Inc
577 mi
Internal Medicine
80 JESSE HILL JR DRIVE, EMCF
Atlanta, GA 30303
  • Reassigned Medicare billing, Georgia enrollment
  • 2,681 clinicians in this Medicare group
NPI 1063452381 (404) 778-7717

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 6

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 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.
42 services37 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.
37 services37 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.
31 services31 patients
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.
15 services15 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.
15 services14 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.
14 services14 patients

Hospital Affiliations CMS Care Compare 4

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

Emory University Hospital

Acute Care Hospitals · Atlanta, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110010
Location1364 Clifton Road, NEAtlanta, GA 30322 · De Kalb County
Emergency services

Emory University Hospital Midtown

Acute Care Hospitals · Atlanta, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110078
Location550 Peachtree Street, NEAtlanta, GA 30308 · Fulton County
Emergency services Birthing friendly

Grady Memorial Hospital

Acute Care Hospitals · Atlanta, GA
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110079
Location80 Jesse Hill, Jr Drive SEAtlanta, GA 30303 · Fulton County
Emergency services Birthing friendly

Saint Joseph's Hospital Of Atlanta, Inc

Acute Care Hospitals · Atlanta, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110082
Location5665 Peachtree Dunwoody RoadAtlanta, GA 30342 · Fulton County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21287 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
$139.05 typical visit price
range $60.73 – $183.44
Typical copayment $34.76 (range $15.18 – $45.86)
Most-billed visit code 99204
Established Patient
$75.47 typical visit price
range $19.60 – $149.17
Typical copayment $18.86 (range $4.90 – $37.29)
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.

94.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality78.49
Promoting Interoperability100
Improvement Activities40
Cost75.54

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.

PAMELA KIMZEY DONOHUE SCD, PA-C
Physician Assistant (Medical)
600 N WOLFE ST, NELSON 2-133
BALTIMORE, MD 21287
Baltimore City (410) 955-5232
MR. CHRISTOPHER DAVID SCHRIEBER M.S., PA-C
Physician Assistant
600 N WOLFE ST, MARBURG B-186
BALTIMORE, MD 21287
Baltimore City (410) 955-8708
DR. SABRINA CHRISTINE SOPHA M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
600 N WOLFE ST
BALTIMORE, MD 21287
Baltimore City (410) 955-3580
SANDRA KING D.H.
Dental Hygienist
600 N WOLFE ST, BLALOCK 266
BALTIMORE, MD 21287
Baltimore City (410) 955-6662
THERESA J RUDDY C.P.N.P., CRNP
Nurse Practitioner (Acute Care)
600 N WOLFE ST
BALTIMORE, MD 21287
Baltimore City (410) 955-5260
DR. SUMAN PAUL M.B.B.S, PHD
Internal Medicine (Medical Oncology)
600 N WOLFE ST
BALTIMORE, MD 21287
Baltimore City (410) 955-5000
MS. SARAH CATHERINE COLLICA
Psychiatry & Neurology (Psychiatry)
600 N WOLFE ST
BALTIMORE, MD 21287
Baltimore City (443) 287-4701
JEFF S EHRESMAN
Student in an Organized Health Care Education/Training Program
600 N WOLFE ST
BALTIMORE, MD 21287
Baltimore City (410) 955-5000

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 Gustavo Pradilla's NPI number?

The NPI number for Gustavo Pradilla is 1659425916. It was assigned to this individual provider in the NPPES registry on January 23, 2007.

Where is Gustavo Pradilla located?

Gustavo Pradilla practices at 600 N Wolfe St Meyer 8-161, Baltimore, MD 21287. The listed phone number is (410) 955-6405.

What is Gustavo Pradilla's specialty?

The primary specialty registered for this NPI is Neurological Surgery with taxonomy code 207T00000X.

Is Gustavo Pradilla enrolled in Medicare?

Yes. Gustavo Pradilla 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 Gustavo Pradilla's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gustavo Pradilla reassigns Medicare benefits to 2 organizations: The Emory Clinic Inc (Atlanta, GA) and Emory Medical Care Foundation Inc (Atlanta, 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 Gustavo Pradilla's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gustavo Pradilla accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Gustavo Pradilla 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 Gustavo Pradilla affiliated with any hospitals?

According to CMS data, Gustavo Pradilla is affiliated with Emory University Hospital, Emory University Hospital Midtown, Grady Memorial Hospital and Saint Joseph's Hospital Of Atlanta, Inc.

When was this NPI record last updated?

The NPPES record for Gustavo Pradilla was last updated on July 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.