DR. PRASHANTH REDDY RAWLA M.D.
NPI 1942596077
Hospitalist in Demorest, GA

Q: What is Prashanth Reddy Rawla's NPI number?

The NPI number for Prashanth Reddy Rawla is 1942596077. It was assigned to this individual provider in the NPPES registry on June 27, 2011.

Q: What is Prashanth Reddy Rawla's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Active since June 27, 2011PECOS EnrolledAccepts Medicare Assignment

94.42/100

CMS Quality Rating

541 441 HISTORIC HWY N, DEMOREST, GA 30535(706) 839-4000 Get Directions Write a Review

NPPES record last updated: April 18, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 12, 2024, Jun 18, 2024 (2 updates tracked since 2024).

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About Dr. Prashanth Reddy Rawla M.d. NPPES

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

DR. PRASHANTH REDDY RAWLA M.D. (NPI 1942596077) is an individual hospitalist provider in Demorest, Georgia, licensed in Georgia (95112) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS, is affiliated with Northeast Georgia Medical Center, Inc, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1942596077

Entity TypeIndividualMale

Primary Taxonomy208M00000X

Provider Legal NameDR. PRASHANTH REDDY RAWLACredential: M.D.

Location Address541 441 HISTORIC HWY NDemorest, GA 30535-4528

Mailing AddressPo Box 742616Atlanta, GA 30374-2616 · (770) 219-8420

Phone(706) 839-4000

Sole ProprietorNo

Medical School CMSOtherGraduated 2005

Enumeration DateJune 27, 2011

Last NPPES UpdateApril 18, 20252 updates tracked since enumeration

NPPES CertifiedApril 18, 2025

✔ NPI 1942596077 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

Licenses✔ Licensed in GA · 95112✔ Licensed in FL · ME136128

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedInternal MedicineTaxonomy 207R00000X · License MD-14659 (IA), 0101257511 (VA)

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

541 441 HISTORIC HWY N, Demorest, GA 30535

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Secondary Practice Locations 2

Location 18117 Preston Rd, Suite 800Dallas, TX 75225-6332 · Phone (214) 666-9528

Location 2106 Broad StLoganville, GA 30052-7463 · Phone (470) 660-4132 · Fax (470) 275-0412

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Medica, Oscar Health Maintenance Organization of Florida and more.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

Dr. Prashanth Reddy Rawla M.d. 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 ID8729203914

PECOS Enrollment IDI20241023003627

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 5

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.

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.

311 services135 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

173 services85 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

159 services152 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

66 services66 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

18 services18 patients

Hospital Affiliations CMS Care Compare 2

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

Northeast Georgia Medical Center, Inc

Acute Care Hospitals · Gainesville, GA

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number110029

Location743 Spring StreetGainesville, GA 30501 · Hall County

Emergency services Birthing friendly

Northeast Georgia Medical Center Habersham

Acute Care Hospitals · Demorest, GA

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110041

Location541 Historic Highway 441-NorthDemorest, GA 30535 · Habersham County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30535 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

$124.10 typical visit price

range $53.31 – $164.04

Typical copayment $31.02 (range $13.32 – $41.01)

Most-billed visit code 99204

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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.

94.42/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

79.08

Improvement Activities

Cost

95.45

Referred Medical Equipment & Supplies CMS DME claims 2

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers12 claims12 services$20.24 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers12 claims12 services$110.77 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 10

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

ADAM E TRAILL DO

Hospitalist