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GOTTUMUKKALA S RAJU MD
NPI 1801955323
Internal Medicine - Gastroenterology in Houston, TX

Active since December 08, 2006PECOS EnrolledAccepts Medicare Assignment
81.38/100
CMS Quality Rating
1515 HOLCOMBE BLVD UNIT 1466, HOUSTON, TX 77030(713) 794-5073(713) 745-5040 Get Directions Write a Review

NPPES record last updated: March 27, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Gottumukkala S Raju Md NPPES

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

GOTTUMUKKALA S RAJU MD (NPI 1801955323) is an individual gastroenterology provider in Houston, Texas, licensed in Texas (L2576) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1982).

NPPES Registry Identity

NPI1801955323
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameGOTTUMUKKALA S RAJUCredential: MD
Location Address1515 HOLCOMBE BLVD UNIT 1466Houston, TX 77030-4000
Mailing Address1515 Holcombe Blvd Unit 1466, The University Of Texas Md Anderson Cancer CenterHouston, TX 77030-4000 · (713) 794-5073 · Fax (713) 745-5040
Phone(713) 794-5073
Fax(713) 745-5040
Sole ProprietorNo
Medical School CMSOtherGraduated 1982
Enumeration DateDecember 8, 2006
Last NPPES UpdateMarch 27, 2012
✔ NPI 1801955323 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 TX · L2576
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.
1515 HOLCOMBE BLVD UNIT 1466, Houston, TX 77030
Open in Google Maps ↗

Other Identifiers 3

Medicare ID-Type Unspecified8789M1TX
Medicaid142193501TX
Medicare UPING16685TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.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

Gottumukkala S Raju 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 ID6103929849
PECOS Enrollment IDI20070316000404
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 Reassignment

Medicare enrollment records show Gottumukkala Raju reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Physicians Referral Service
Same address
Multi-Specialty
1515 HOLCOMBE BLVD
Houston, TX 77030
  • Reassigned Medicare billing, Texas enrollment
  • 2,675 clinicians in this Medicare group
NPI 1073574810 (713) 792-6161

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 12

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.
76 services62 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.
74 services72 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
59 services59 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.
58 services56 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.
54 services41 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.
43 services42 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77030 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
$134.06 typical visit price
range $58.24 – $176.98
Typical copayment $33.51 (range $14.56 – $44.24)
Most-billed visit code 99204
Established Patient
$102.71 typical visit price
range $18.60 – $143.93
Typical copayment $25.67 (range $4.65 – $35.98)
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.

81.38/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.25
Promoting Interoperability100
Improvement Activities40
Cost49.97

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 Gottumukkala Raju's NPI number?

The NPI number for Gottumukkala Raju is 1801955323. It was assigned to this individual provider in the NPPES registry on December 8, 2006.

Where is Gottumukkala Raju located?

Gottumukkala Raju practices at 1515 Holcombe Blvd Unit 1466, Houston, TX 77030. The listed phone number is (713) 794-5073.

What is Gottumukkala Raju's specialty?

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

Is Gottumukkala Raju enrolled in Medicare?

Yes. Gottumukkala Raju 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 organization bills Medicare for Gottumukkala Raju's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gottumukkala Raju reassigns Medicare benefits to Physicians Referral Service (Houston, TX). The 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 Gottumukkala Raju's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gottumukkala Raju accept?

Health plans from Blue Cross and Blue Shield of Texas list Gottumukkala Raju 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.

When was this NPI record last updated?

The NPPES record for Gottumukkala Raju was last updated on March 27, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.