SWAPNA GUMMADI MD
NPI 1962632638
Hospitalist in West Chester, PA

Active since July 16, 2009PECOS EnrolledAccepts Medicare Assignment
701 E MARSHALL ST, WEST CHESTER, PA 19380(610) 431-5000 Get Directions Write a Review

NPPES record last updated: November 10, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Swapna Gummadi Md NPPES

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

SWAPNA GUMMADI MD (NPI 1962632638) is an individual hospitalist provider in West Chester, Pennsylvania, licensed in Pennsylvania (MD459409) and active in the NPI registry since July 2009. She is enrolled in Medicare PECOS, is affiliated with Hospital Of Univ Of Pennsylvania, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1962632638
Entity TypeIndividualFemale
Primary Taxonomy208M00000X
Provider Legal NameSWAPNA GUMMADICredential: MD
Location Address701 E MARSHALL STWest Chester, PA 19380-4412
Mailing Address701 E Marshall StWest Chester, PA 19380-4412 · (610) 431-5000
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateJuly 16, 2009
Last NPPES UpdateNovember 10, 2016
NPI 1962632638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License Licensed in PA · MD459409
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.
701 E MARSHALL ST, West Chester, PA 19380

Accepted 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

Swapna Gummadi 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 ID1355598061
PECOS Enrollment IDI20161220001924
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 6

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.
747 services343 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.
173 services169 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.
109 services79 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
85 services85 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.
50 services50 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.
35 services34 patients

Hospital Affiliations CMS Care Compare 2

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

Hospital Of Univ Of Pennsylvania

Acute Care Hospitals · Philadelphia, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390111
Location34th & Spruce StsPhiladelphia, PA 19104 · Philadelphia County
Emergency services Birthing friendly

Chester County Hospital

Acute Care Hospitals · West Chester, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390179
Location701 East Marshall StreetWest Chester, PA 19380 · Chester County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19380 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
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
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.

Referred Medical Equipment & Supplies CMS DME claims 5

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

Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) A4221
DME-Other DME · category DE017N
1 supplier41 claims41 services$18.45 avg. paid by Medicare
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) A4222
DME-Medical/Surgical Supplies · category DA000N
1 supplier42 claims145 services$35.91 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers18 claims18 services$14.05 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 suppliers18 claims18 services$67.46 avg. paid by Medicare
Injection, milrinone lactate, 5 mg J2260
Treatment-Injections and Infusions (nononcologic) · category RI026N
1 supplier42 claims2,744 services$1.30 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 20

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

Registered Nurse
701 E MARSHALL ST
WEST CHESTER, PA 19380
General Acute Care Hospital
701 E MARSHALL ST
WEST CHESTER, PA 19380
Physician Assistant
701 E MARSHALL ST
WEST CHESTER, PA 19380
Nurse Anesthetist, Certified Registered
701 E MARSHALL ST, NRW 141
WEST CHESTER, PA 19380
Physician Assistant (Medical)
701 E MARSHALL ST
WEST CHESTER, PA 19380
Emergency Medicine
701 E MARSHALL ST
WEST CHESTER, PA 19380
Hospitalist
701 E MARSHALL ST
WEST CHESTER, PA 19380
Pediatrics
701 E MARSHALL ST
WEST CHESTER, PA 19380

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 Swapna Gummadi's NPI number?

The NPI number for Swapna Gummadi is 1962632638. It was assigned to this individual provider in the NPPES registry on July 16, 2009.

Where is Swapna Gummadi located?

Swapna Gummadi practices at 701 E Marshall St, West Chester, PA 19380. The listed phone number is (610) 431-5000.

What is Swapna Gummadi's specialty?

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

Is Swapna Gummadi enrolled in Medicare?

Yes. Swapna Gummadi 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.

What insurance does Swapna Gummadi accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Swapna Gummadi 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 Swapna Gummadi affiliated with any hospitals?

According to CMS data, Swapna Gummadi is affiliated with Hospital Of Univ Of Pennsylvania and Chester County Hospital.

When was this NPI record last updated?

The NPPES record for Swapna Gummadi was last updated on November 10, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.