SUSMITHA NIMMAGADDA MD
NPI 1689847436
Internal Medicine - Hematology & Oncology in Prattville, AL

Active since April 11, 2008PECOS EnrolledAccepts Medicare Assignment
80.87/100
CMS Quality Rating
645 MCQUEEN SMITH ROAD, SUITE 207, PRATTVILLE, AL 36066(334) 351-1000(334) 273-2228 Get Directions Write a Review

NPPES record last updated: August 20, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 20, 2024, Jun 13, 2024, Jul 18, 2023 and 1 more (4 updates tracked since 2023).

About Susmitha Nimmagadda Md NPPES

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

SUSMITHA NIMMAGADDA MD (NPI 1689847436) is an individual hematology & oncology provider in Prattville, Alabama, licensed in Alabama (29950) and active in the NPI registry since April 2008. She is enrolled in Medicare PECOS, maintains a secondary practice location in Montgomery, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1689847436
Entity TypeIndividualFemale
Primary Taxonomy207RH0003X
Provider Legal NameSUSMITHA NIMMAGADDACredential: MD
Location Address645 MCQUEEN SMITH ROAD, SUITE 207Prattville, AL 36066-7263
Mailing Address4145 Carmichael RdMontgomery, AL 36106-2803 · (334) 273-7000
Fax(334) 273-2228
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateApril 11, 2008
Last NPPES UpdateAugust 20, 20244 updates tracked since enumeration
NPPES CertifiedAugust 20, 2024
NPI 1689847436 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
License Licensed in AL · 29950
Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

645 MCQUEEN SMITH ROAD, Prattville, AL 36066

Secondary Practice Location 1

Location 14145 Carmichael RdMontgomery, AL 36106-2803 · Phone (334) 273-7000

Accepted 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

Susmitha Nimmagadda 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 ID4789858408
PECOS Enrollment IDI20111115000580
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 4

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.
232 services133 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.
186 services98 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.
74 services62 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
48 services48 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36066 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
$161.63 typical visit price
range $52.65 – $161.63
Typical copayment $40.40 (range $13.16 – $40.40)
Most-billed visit code 99205
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
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.

80.87/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality76.7
Promoting Interoperability100
Improvement Activities40
Cost59.55

Other Providers at the Same Location NPPES 2

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

Specialist
645 MCQUEEN SMITH ROAD, SUITE 205
PRATTVILLE, AL 36066
Internal Medicine (Hematology & Oncology)
645 MCQUEEN SMITH ROAD, SUITE 207
PRATTVILLE, AL 36066

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1689847436, enumerated as an "individual" on April 11, 2008.

The provider is located at 645 MCQUEEN SMITH ROAD SUITE 207 PRATTVILLE, AL 36066 and the phone number is (334) 351-1000.

Internal Medicine with taxonomy code 207RH0003X and a focus in Hematology & Oncology.

The provider might be accepting Accepts: Ambetter from Magnolia Health, Ambetter Health,. Please consult your insurance carrier or call the provider to verify.