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DR. PRABHAVATHI GUMMALLA M.D
NPI 1750700852
Pediatrics - Pediatric Pulmonology in Philadelphia, PA

Active since April 16, 2014PECOS Enrolled
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104(917) 715-5360 Get Directions Write a Review

NPPES record last updated: February 9, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 9, 2023, Apr 30, 2019, Apr 26, 2019 (3 updates tracked since 2019).

About Dr. Prabhavathi Gummalla M.d NPPES

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

DR. PRABHAVATHI GUMMALLA M.D (NPI 1750700852) is an individual pediatric pulmonology provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD458931) and active in the NPI registry since April 2014. She is enrolled in Medicare PECOS and maintains a secondary practice location in Voorhees.

NPPES Registry Identity

NPI1750700852
Entity TypeIndividualFemale
Primary Taxonomy2080P0214X
Provider Legal NameDR. PRABHAVATHI GUMMALLACredential: M.D
Location Address3401 CIVIC CENTER BLVDPhiladelphia, PA 19104-4319
Mailing Address2-10 Linden AveHaddonfield, NJ 08033-2556 · (917) 715-5360
Phone(917) 715-5360
Sole ProprietorYes
Enumeration DateApril 16, 2014
Last NPPES UpdateFebruary 9, 20233 updates tracked since enumeration
NPPES CertifiedFebruary 9, 2023
✔ NPI 1750700852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric PulmonologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0214X
Licenses✔ Licensed in PA · MD458931✔ Licensed in NJ · 25MA10793600✔ Licensed in NY · 285065
Definition
A pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques.
Also ListedPediatrics · Sleep MedicineTaxonomy 2080S0012X · License MD458931 (PA), 25MA10793600 (NJ)
3401 CIVIC CENTER BLVD, Philadelphia, PA 19104
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Secondary Practice Location 1

Location 1200 Bowman DrVoorhees, NJ 08043-9623 · Phone (215) 590-7490

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Prabhavathi Gummalla M.d is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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

3

Medicare enrollment records show Prabhavathi Gummalla reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Childrens Health Care Associates, Inc
Same address
Neurology
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA
Philadelphia, PA 19104
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 1,225 clinicians in this Medicare group
NPI 1033204086 (215) 590-1000
Children's Health Care Associates Of New Jersey PC
14 mi
Pediatrics
1012 LAUREL OAK RD, SPECIALTY CENTER AT VOORHEES - CHOP
Voorhees, NJ 08043
  • Reassigned Medicare billing, New Jersey enrollment
  • 190 clinicians in this Medicare group
NPI 1669567681 (856) 435-1300
Valley Physician Services PC
90 mi
Internal Medicine
15 ESSEX RD
Paramus, NJ 07652
  • Reassigned Medicare billing, New Jersey enrollment
  • 833 clinicians in this Medicare group
NPI 1467815928 (201) 291-6086

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
1 supplier16 claims16 services$34.43 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
1 supplier17 claims102 services$15.85 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
1 supplier22 claims22 services$47.03 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
1 supplier11 claims11 services$15.74 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
1 supplier18 claims108 services$1.80 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.

AARON DORFMAN M.D.
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - CARDIOLOGY
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-4040
MS. NICOLE MARIE KOEPKE CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - EMERGENCY MED
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1944
DR. CASSANDRA ALYS LIGH MD
Surgery (Plastic and Reconstructive Surgery)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-2208
DR. PREETI SOI
Psychiatry & Neurology (Child & Adolescent Psychiatry)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-7555
ROSALIND USHER M.D.
Pediatrics (Developmental - Behavioral Pediatrics)
3401 CIVIC CENTER BLVD, DIVISION OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-6336
DR. MATTHEW DAVID SCHREIER MD
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
DR. TERRENCE CALDWELL JR. PHARMD
Pharmacist (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
ALYSSA STIEFEL CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000

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 Prabhavathi Gummalla's NPI number?

The NPI number for Prabhavathi Gummalla is 1750700852. It was assigned to this individual provider in the NPPES registry on April 16, 2014.

Where is Prabhavathi Gummalla located?

Prabhavathi Gummalla practices at 3401 Civic Center Blvd, Philadelphia, PA 19104. The listed phone number is (917) 715-5360.

What is Prabhavathi Gummalla's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Pulmonology, with taxonomy code 2080P0214X.

Is Prabhavathi Gummalla enrolled in Medicare?

Yes. Prabhavathi Gummalla is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Prabhavathi Gummalla's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Prabhavathi Gummalla reassigns Medicare benefits to 3 organizations: Childrens Health Care Associates, Inc (Philadelphia, PA), Children's Health Care Associates Of New Jersey PC (Voorhees, NJ) and Valley Physician Services PC (Paramus, NJ). 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 Prabhavathi Gummalla's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Prabhavathi Gummalla was last updated on February 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.