DR. KAVITA S BOMMASAMUDRAM MD
NPI 1922589449
Psychiatry & Neurology - Psychiatry in Wilkes Barre, PA

Q: What is Kavita Bommasamudram's NPI number?

The NPI number for Kavita Bommasamudram is 1922589449. It was assigned to this individual provider in the NPPES registry on August 23, 2018.

Q: What is Kavita Bommasamudram's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Active since August 23, 2018PECOS Enrolled

8 CHURCH ST, WILKES BARRE, PA 18702(570) 808-3700 Get Directions Write a Review

NPPES record last updated: November 1, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 1, 2021, Jul 22, 2019, Aug 23, 2018 (3 updates tracked since 2018).

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About Dr. Kavita S Bommasamudram Md NPPES

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

DR. KAVITA S BOMMASAMUDRAM MD (NPI 1922589449) is an individual psychiatry provider in Wilkes Barre, Pennsylvania, licensed in Pennsylvania (MD471297) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS and maintains a secondary practice location in Elizabeth.

NPPES Registry Identity

NPI1922589449

Entity TypeIndividualFemale

Primary Taxonomy2084P0800X

Provider Legal NameDR. KAVITA S BOMMASAMUDRAMCredential: MD

Location Address8 CHURCH STWilkes Barre, PA 18702-3542

Mailing Address655 E. Livingston St.Elizabeth, NJ 07206

Phone(570) 808-3700

Sole ProprietorNo

Enumeration DateAugust 23, 2018

Last NPPES UpdateNovember 1, 20213 updates tracked since enumeration

NPPES CertifiedOctober 6, 2021

✔ NPI 1922589449 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

License✔ Licensed in PA · MD471297

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

8 CHURCH ST, Wilkes Barre, PA 18702

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Secondary Practice Location 1

Location 1655 Livingston StElizabeth, NJ 07206 · Phone (908) 994-5000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kavita S Bommasamudram Md 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 Reassignment

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

Geisinger Clinic

1.6 mi

Family Medicine

41 S MAIN ST
Wilkes Barre, PA 18701

Reassigned Medicare billing, Pennsylvania enrollment
4,429 clinicians in this Medicare group

NPI 1629681150 (570) 846-4777

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18702 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

$166.87 typical visit price

range $54.64 – $166.87

Typical copayment $41.71 (range $13.66 – $41.71)

Most-billed visit code 99205

Established Patient

$68.36 typical visit price

range $17.33 – $135.84

Typical copayment $17.09 (range $4.33 – $33.96)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

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

DR. MATTHEW JAMES KAHARI MD

Family Medicine (Addiction Medicine)