PRAVEEN GOWTHAM VARMA DASARAJU
NPI 1962107649
Internal Medicine in Jamestown, NY

Q: What is Praveen Gowtham Varma Dasaraju's NPI number?

The NPI number for Praveen Gowtham Varma Dasaraju is 1962107649. It was assigned to this individual provider in the NPPES registry on April 3, 2023.

Q: What is Praveen Gowtham Varma Dasaraju's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since April 03, 2023PECOS Enrolled

15 S MAIN ST STE 150, JAMESTOWN, NY 14701(716) 483-6700 Get Directions Write a Review

NPPES record last updated: July 15, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Jul 15, 2026, Apr 3, 2023 (2 updates tracked since 2023).

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About Praveen Gowtham Varma Dasaraju NPPES

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

PRAVEEN GOWTHAM VARMA DASARAJU (NPI 1962107649) is an individual internal medicine provider in Jamestown, New York, licensed in New York (345584-01) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962107649

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NamePRAVEEN GOWTHAM VARMA DASARAJU

Location Address15 S MAIN ST STE 150Jamestown, NY 14701-6627

Mailing Address15 S Main St Ste 150Jamestown, NY 14701-6627 · (716) 483-6700

Phone(716) 483-6700

Sole ProprietorNo

Enumeration DateApril 3, 2023

Last NPPES UpdateJuly 15, 20262 updates tracked since enumeration

NPPES CertifiedJuly 15, 2026

✔ NPI 1962107649 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in NY · 345584-01

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

15 S MAIN ST STE 150, Jamestown, NY 14701

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Praveen Gowtham Varma Dasaraju 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14701 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

$126.40 typical visit price

range $54.87 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

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.

Other Providers at the Same Location NPPES 9

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

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