PRABHAKAR RUMALLA M.D.
NPI 1669404943
Internal Medicine - Gastroenterology in Ocala, FL

Q: What is Prabhakar Rumalla's NPI number?

The NPI number for Prabhakar Rumalla is 1669404943. It was assigned to this individual provider in the NPPES registry on July 7, 2006.

Q: What is Prabhakar Rumalla's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Prabhakar Rumalla was last updated on July 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 July 07, 2006PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

1901 SE 18TH AVE, BLDG # 400, OCALA, FL 34471(352) 732-8905(352) 732-2440 Get Directions Write a Review

NPPES record last updated: July 6, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 6, 2022, Nov 30, 2021, Apr 12, 2021 and 3 more (6 updates tracked since 2018).

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About Prabhakar Rumalla M.d. NPPES

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

PRABHAKAR RUMALLA M.D. (NPI 1669404943) is an individual gastroenterology provider in Ocala, Florida, licensed in Florida (ME31901) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Adventhealth Ocala, and is a graduate of Other (1968).

NPPES Registry Identity

NPI1669404943

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NamePRABHAKAR RUMALLACredential: M.D.

Location Address1901 SE 18TH AVE, BLDG # 400Ocala, FL 34471-8215

Mailing Address1901 Se 18th Ave, Bldg # 400Ocala, FL 34471-8215 · (352) 732-8905 · Fax (352) 732-2440

Phone(352) 732-8905

Fax(352) 732-2440

Sole ProprietorNo

Medical School CMSOtherGraduated 1968

Enumeration DateJuly 7, 2006

Last NPPES UpdateJuly 6, 20226 updates tracked since enumeration

NPPES CertifiedJuly 6, 2022

✔ NPI 1669404943 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in FL · ME31901

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

1901 SE 18TH AVE, Ocala, FL 34471

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Other Identifiers 1

Medicaid036980200FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Health First Commercial Plans, Inc. 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

Prabhakar Rumalla 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 ID7719973056

PECOS Enrollment IDI20100923000423

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 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.

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.

103 services98 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

92 services92 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

71 services71 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.

57 services50 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

45 services45 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

43 services43 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.

42 services42 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

32 services32 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

25 services25 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.

24 services24 patients

Insertion of guide wire with dilation of esophagus using a flexible endoscope 43248

This is a procedure where a thin tube, called an endoscope, is gently passed through your mouth into your esophagus. A guide wire is then inserted to help widen any narrow areas. This helps improve swallowing and reduce discomfort.

21 services20 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

21 services21 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

19 services19 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.

16 services16 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.

13 services11 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.

13 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Adventhealth Ocala

Acute Care Hospitals · Ocala, FL

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100062

Location1500 SW 1st AveOcala, FL 34474 · Marion County

Emergency services Birthing friendly

Marion Communtiy Hospital

Acute Care Hospitals · Ocala, FL

1/5 CMS rating

OwnershipProprietary

CMS Certification Number100212

Location1431 SW 1st AveOcala, FL 34471 · Marion County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34471 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

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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.

100/100

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

Scored as part of a group practice

Promoting Interoperability

100

Improvement Activities

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.

DINESH S RAO MD

Urology

1901 SE 18TH AVE, BLDG 300
OCALA, FL 34471

Marion County (352) 351-1313

JARED A DESTACKELBERG PA

Physician Assistant

1901 SE 18TH AVE, STE 101
OCALA, FL 34471

Marion County (352) 622-3360

STEPHANIE NICOLE HEALD APRN

Nurse Practitioner (Family)

1901 SE 18TH AVE
OCALA, FL 34471

Marion County (352) 351-1313

EDWARD D KING MD

Urology

1901 SE 18TH AVE, BLDG 300
OCALA, FL 34471

Marion County (352) 351-1313

RICHARD B VANELDIK M.D.

Internal Medicine (Gastroenterology)

1901 SE 18TH AVE, BUILDING # 400
OCALA, FL 34471

Marion County (352) 732-8905

MARSHA CORBIN MCDANIEL PT, MBA

Physical Therapist

1901 SE 18TH AVE, BUILDING 500
OCALA, FL 34471

Marion County (352) 351-1474

MIGUEL A QUINTANA JR. PT

Physical Therapist (Orthopedic)

1901 SE 18TH AVE, STE 102
OCALA, FL 34471

Marion County (352) 789-6776

ANTONIO DISCLAFANI II MD

Neurological Surgery

1901 SE 18TH AVE, SUITE 101
OCALA, FL 34471

Marion County (352) 622-3360

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 Prabhakar Rumalla's NPI number?

The NPI number for Prabhakar Rumalla is 1669404943. It was assigned to this individual provider in the NPPES registry on July 7, 2006.

Where is Prabhakar Rumalla located?

Prabhakar Rumalla practices at 1901 SE 18th Ave Bldg # 400, Ocala, FL 34471. The listed phone number is (352) 732-8905.

What is Prabhakar Rumalla's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Prabhakar Rumalla enrolled in Medicare?

Yes. Prabhakar Rumalla 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 Prabhakar Rumalla accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Health First Commercial Plans, Inc., Oscar Health Maintenance Organization of Florida and UnitedHealthcare list Prabhakar Rumalla 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 Prabhakar Rumalla affiliated with any hospitals?

According to CMS data, Prabhakar Rumalla is affiliated with Adventhealth Ocala and Marion Communtiy Hospital.

When was this NPI record last updated?

The NPPES record for Prabhakar Rumalla was last updated on July 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.