Pavan Kumar Punukollu, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

269048 Issued in MA

Practice address

1 General St
Lawrence, MA 01841-2961

Phone

(978) 683-4000

NPI assigned

Mar 24, 2006

Last updated

Oct 16, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in OH, FL, MA, TX, SC, TN, NC7 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 7

Specialty

Diagnostic Radiology

Education

Tufts University School of Medicine, 1992

Medicare assignment

May accept Medicare assignment

Group practices

Radiology Associates of North Texas PAGroup PAC ID 7911897301, 340 clinicians

L and M Radiology IncGroup PAC ID 6305819228, 20 clinicians

Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians

Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Colonial Family Practice LLCGroup PAC ID 9931017118, 58 clinicians

Quantum Imaging and Therapeutic Associates IncGroup PAC ID 1355254129, 92 clinicians

Penn State Health Medical Group LLCGroup PAC ID 8729351077, 720 clinicians

Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Upmc Pinnacle Hospitals Hospital, Harrisburg, PA, CCN 390067
• Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801
• Longview Regional Medical Center Hospital, Longview, TX, CCN 450702
• Upmc Carlisle Hospital, Carlisle, PA, CCN 390058
• Upmc Memorial Hospital, York, PA, CCN 390101

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: pavan.punukulu.p1@direct.beaconortho.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• L & M Radiology, Inc.

  • Diagnostic Radiology Physician
  • Lawrence, MA
  • NPI 1699721985
  Medicare reassignment Care Compare group NPD
• Colonial Family Practice, LLC

  dba Colonial Family Practice

  • Family Medicine Physician
  • Sumter, SC
  • NPI 1518074640
  Medicare reassignment Care Compare group NPD
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1811122880
  Medicare reassignment Care Compare group NPD
• Penn State Health Medical Group, LLC

  • Diagnostic Radiology Physician
  • Harrisburg, PA
  • NPI 1457824013

  MA

  Medicare reassignment Care Compare group NPD
• Quantum Imaging & Therapeutic Associates Inc

  • Diagnostic Radiology Physician
  • Lewisberry, PA
  • NPI 1609863893

  MA

  Medicare reassignment Care Compare group NPD
• Radiology Associates of North Texas PA

  • Diagnostic Radiology Physician
  • Fort Worth, TX
  • NPI 1710970975

  MA

  Medicare reassignment Care Compare group NPD
• Summit Medical Group, PLLC

  dba Cool Springs Internal Medicine and Pediatrics

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1659090298
  Medicare reassignment Care Compare group NPD
• Wilmington Health PLLC

  • Multi-Specialty Clinic/Center
  • Wilmington, NC
  • NPI 1881632339
  Medicare reassignment Care Compare group
• Optumcare New Mexico LLC

  dba DaVita Medical Group

  • Family Medicine Physician
  • Albuquerque, NM
  • NPI 1124053210

  MA

  Medicare reassignment NPD
• Beacon Orthopaedics & Sports Medicine, LTD

  dba OrthoAlliance of Ohio

  • Specialist
  • Cincinnati, OH
  • NPI 1386670065
  Medicare reassignment
• Hartsville Medical Group LLC

  • Internal Medicine Physician
  • Hartsville, SC
  • NPI 1598995300
  Medicare reassignment
• Colonial Family Practice, LLC

  dba Colonial Family Practice Liberty Street Location

  • Family Medicine Physician
  • Sumter, SC
  • NPI 1225687338
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christus Health Ark-la-Tex

  dba Christus St. Michael Health System

  • General Practice Physician
  • Texarkana, TX
  • NPI 1184623266

  Hospital

  Care Compare affiliation
• Christus Health Ark-la-Tex

  dba CHRISTUS St. Michael Health System

  • General Acute Care Hospital
  • Texarkana, TX
  • NPI 1295736734
  Care Compare affiliation
• Longview Medical Center LP

  dba Longview Regional Medical Center

  • General Acute Care Hospital
  • Longview, TX
  • NPI 1528026267
  Care Compare affiliation
• Upmc Carlisle

  • General Acute Care Hospital
  • Carlisle, PA
  • NPI 1689107328
  Care Compare affiliation
• Upmc Carlisle

  • Ambulatory Surgical Clinic/Center
  • Carlisle, PA
  • NPI 1972038826

  Hospital

  Care Compare affiliation
• Upmc Memorial

  • General Acute Care Hospital
  • York, PA
  • NPI 1063945707
  Care Compare affiliation
• Upmc Memorial

  • Ambulatory Surgical Clinic/Center
  • York, PA
  • NPI 1235664186

  Hospital

  Care Compare affiliation
• Upmc Pinnacle Hospitals

  • Ambulatory Surgical Clinic/Center
  • Harrisburg, PA
  • NPI 1164526588

  Hospital

  Care Compare affiliation
• Upmc Pinnacle Hospitals

  • General Acute Care Hospital
  • Harrisburg, PA
  • NPI 1265537674
  Care Compare affiliation
• Upmc Pinnacle Hospitals

  • Ambulatory Surgical Clinic/Center
  • Harrisburg, PA
  • NPI 1346344769

  Hospital

  Care Compare affiliation
• Upmc Pinnacle Hospitals

  • General Acute Care Hospital
  • Harrisburg, PA
  • NPI 1407813603
  Care Compare affiliation
• Upmc Pinnacle Hospitals

  • Ambulatory Surgical Clinic/Center
  • Harrisburg, PA
  • NPI 1528940962

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1366402273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2527 CRANBERRY HWY",
            "city": "WAREHAM",
            "state": "MA",
            "postal_code": "025711046",
            "telephone_number": "800-841-5200",
            "fax_number": "508-273-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENERAL ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412961",
            "telephone_number": "978-683-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13813 Metro Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339124343",
            "country_code": "US",
            "telephone_number": "855-674-4624",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7211 Wellington Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379195968",
            "country_code": "US",
            "telephone_number": "865-588-8005",
            "fax_number": "886-558-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "585 Lebanon St",
            "address_purpose": "LOCATION",
            "city": "Melrose",
            "state": "MA",
            "postal_code": "021763225",
            "country_code": "US",
            "telephone_number": "781-979-3120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUNUKOLLU",
        "first_name": "PAVAN",
        "middle_name": "KUMAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME130248",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.074221",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "269048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110131865A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "JA839Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11286315",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000241778",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300132093",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Procare Transportation LLC
• Nicole Ann Provencher
• Cheryl Puerling, PSY.D.
• Puerta de Luz Medical Supplies Inc
• Jean C Puleo, BS-RPH
• Elizabeth Grace Purcell
• Evan Purcell
• Maosong Qi, M.D., PHD
• Quality Human Services, LLC
• Quality Life Lawrence, LLC (Quality Life Adult Day Services #44)

• Diagnostic Radiology Physician in Lawrence, MA
• Providers in Lawrence, MA by specialty
• Diagnostic Radiology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.