DR. PRASHANTH REDDY RAWLA M.D.
NPI 1942596077
Hospitalist in Demorest, GA
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
Specialties & Licenses 3
Secondary Practice Locations 2
Accepted 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
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.
Medicare Billing Reassignments
4Medicare enrollment records show Prashanth Reddy Rawla reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Gainesville, GA 30501
- Reassigned Medicare billing, Georgia enrollment
- 1,172 clinicians in this Medicare group
Loganville, GA 30052
- Reassigned Medicare billing, Georgia enrollment
- 3 clinicians in this Medicare group
Greensboro, NC 27407
- Reassigned Medicare billing, North Carolina enrollment
- 691 clinicians in this Medicare group
Titusville, FL 32796
- Reassigned Medicare billing, Florida enrollment
- 160 clinicians in this Medicare group
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 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.
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, GANortheast Georgia Medical Center Habersham
Acute Care Hospitals · Demorest, GAPhysician 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.
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.
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.
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.
DEMOREST, GA 30535
DEMOREST, GA 30535
DEMOREST, GA 30535
DEMOREST, GA 30535
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 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.
Where is Prashanth Reddy Rawla located?
Prashanth Reddy Rawla practices at 541 441 Historic Hwy N, Demorest, GA 30535. The listed phone number is (706) 839-4000.
What is Prashanth Reddy Rawla's specialty?
The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.
Is Prashanth Reddy Rawla enrolled in Medicare?
Yes. Prashanth Reddy Rawla 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 organizations bill Medicare for Prashanth Reddy Rawla's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Prashanth Reddy Rawla reassigns Medicare benefits to 4 organizations: Northeast Georgia Physicians Group Inc (Gainesville, GA), Mdcare Clinic LLC (Loganville, GA), Moses Cone Physician Services, Inc. (Greensboro, NC) and Apogee Medical Group, Florida, Inc. (Titusville, FL). 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 Prashanth Reddy Rawla's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Prashanth Reddy Rawla accept?
Health plans from Alliant Health Plans, Inc., Oscar Health, Oscar Health Maintenance Organization of Florida, Oscar Insurance Company and Wellmark Health Plan of Iowa, Inc. list Prashanth Reddy Rawla 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.
Is Prashanth Reddy Rawla affiliated with any hospitals?
According to CMS data, Prashanth Reddy Rawla is affiliated with Northeast Georgia Medical Center, Inc and Northeast Georgia Medical Center Habersham.
When was this NPI record last updated?
The NPPES record for Prashanth Reddy Rawla was last updated on April 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.
# Dr. Prashanth Reddy Rawla, M.D. · NPI 1942596077
Hospitalist physician in Demorest, Georgia. Individual provider, active in the CMS NPPES registry since June 27, 2011.
## Identity
- **NPI:** 1942596077 (Entity type: Individual)
- **Enumerated:** June 27, 2011
- **Primary specialty:** Hospitalist · taxonomy 208M00000X
- **State license:** 95112 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 541 441 HISTORIC HWY N, Demorest, GA 30535-4528
- **Phone:** (706) 839-4000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Northeast Georgia Physicians Group Inc (NPI 1891745212, Gainesville, GA); Mdcare Clinic LLC (NPI 1932947751, Loganville, GA); Moses Cone Physician Services, Inc. (NPI 1528664596, Greensboro, NC); Apogee Medical Group, Florida, Inc. (NPI 1386916104, Titusville, FL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2005
## Record status
- **NPPES last updated:** April 18, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1942596077) · Data from the CMS NPPES public registry.