SAI SWAPNIKA GUTTIKONDA MD
NPI 1689134835
Family Medicine in Franklin, PA

Active since March 23, 2019PECOS EnrolledAccepts Medicare Assignment
78.53/100
CMS Quality Rating
464 ALLEGHENY BLVD STE 2D, FRANKLIN, PA 16323(814) 437-6793 Get Directions Write a Review

NPPES record last updated: August 11, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 11, 2022, Jul 6, 2022, Mar 23, 2019 (3 updates tracked since 2019).

About Sai Swapnika Guttikonda Md NPPES

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

SAI SWAPNIKA GUTTIKONDA MD (NPI 1689134835) is an individual family medicine provider in Franklin, Pennsylvania, licensed in Pennsylvania (MD478398) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS, is affiliated with Upmc Northwest, and maintains a secondary practice location in Danville.

NPPES Registry Identity

NPI1689134835
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameSAI SWAPNIKA GUTTIKONDACredential: MD
Location Address464 ALLEGHENY BLVD STE 2DFranklin, PA 16323-6259
Mailing Address464 Allegheny Blvd Ste 2dFranklin, PA 16323-6259 · (814) 437-6793
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateMarch 23, 2019
Last NPPES UpdateAugust 11, 20223 updates tracked since enumeration
NPPES CertifiedAugust 11, 2022
NPI 1689134835 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in PA · MD478398
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

464 ALLEGHENY BLVD STE 2D, Franklin, PA 16323

Other Names 1

Former Name (1)Sai Swapnika Ghanta M.b;b.s

Secondary Practice Location 1

Location 1Geisinger Medical Center 100 North Academy AvenueDanville, PA 17822-0001 · Phone (570) 271-6211

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

Sai Swapnika Guttikonda Md 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 ID9638405947
PECOS Enrollment IDI20220812002219
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 8

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 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.
411 services221 patients
Anticoagulant management of patient taking warfarin 93793
Anticoagulant management with warfarin involves monitoring and adjusting your medication to prevent blood clots while minimizing the risk of bleeding. Regular blood tests measure your response to warfarin, helping adjust your dose if necessary. It's crucial to maintain a consistent diet and promptly report any changes in your health.
238 services12 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.
58 services50 patients
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438
An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.
41 services41 patients
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180
This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
31 services23 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.
25 services25 patients

Hospital Affiliations CMS Care Compare

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

Upmc Northwest

Acute Care Hospitals · Seneca, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390091
Location100 Fairfield DriveSeneca, PA 16346 · Venango County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16323 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
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

78.53/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality74.61
Promoting Interoperability100
Improvement Activities40
Cost53.82

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Urology
464 ALLEGHENY BLVD STE 2D
FRANKLIN, PA 16323
Family Medicine
464 ALLEGHENY BLVD STE 2D, SUITE 2D, PENNWOOD CENTER
FRANKLIN, PA 16323
Family Medicine
464 ALLEGHENY BLVD STE 2D
FRANKLIN, PA 16323
Physician Assistant
464 ALLEGHENY BLVD STE 2D
FRANKLIN, PA 16323

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1689134835, enumerated as an "individual" on March 23, 2019.

The provider is located at 464 ALLEGHENY BLVD STE 2D FRANKLIN, PA 16323 and the phone number is (814) 437-6793.

Family Medicine with taxonomy code 207Q00000X.

Sai Swapnika Guttikonda is affiliated with: UPMC NORTHWEST.