NPIMap

Individual provider Active NPI

Pavani Pagolu, MD

  • Internal Medicine Physician
  • West Reading, PA
National Provider Identifier
1861600116
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD434770 Issued in PA
Practice address
420 S 5TH Ave
West Reading, PA 19611-2143
Phone
(484) 628-5455
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD434770 PA Primary

Addresses

Primary practice location

420 S 5TH Ave
West Reading, PA 19611-2143

Mailing address

PO Box 13579
Reading, PA 19612-3579
Phone (484) 628-0799

Other practice location 1

6th Avenue & Spruce Street
West Reading, PA 19611
Phone (610) 988-8446

Other identifiers 1

IdentifierTypeStateIssuer
102396494MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081103000366 PA Practitioner - HospitalistPractitioner - Internal Medicine 5496814683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tower Health Medical GroupGroup PAC ID 7618889213, 578 clinicians

Practice addresses (Care Compare)

2610 Keiser Blvd
Wyomissing, PA 19610-3333
Phone (484) 750-3950

301 S 7TH Ave
Radiology Tower Health Medical Group
West Reading, PA 19611-1442
Phone (484) 628-8112

420 S 5TH Ave
West Reading, PA 19611-2143

Hospital & facility affiliations

  • Tower Health at Home Home health agency, West Reading, PA, CCN 397001
  • Tower Health at Home - Berks Hospice, Reading, PA, CCN 391536
  • Reading Hospital Hospital, West Reading, PA, CCN 390044

Merit-based Incentive Payment System (MIPS)

Final score
84.71 of 100Reported as group
Quality
73.34
Promoting interoperability
97
Improvement activities
40
Cost
78.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Health Medical Group Internal Medicine Current Accepting new patients
Tower Health Medical Group CurrentSince Jul 7, 2008 Accepting new patients
Tower Health Medical Group CurrentSince Jul 7, 2008 Accepting new patients
Reading Hospital Internal Medicine Past Accepting new patients

Locations

6 Spruce St
West Reading, PA 19611
Phone (484) 628-8269

420 S 5th Ave
West Reading, PA 19611
Phone (484) 628-3637

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

Organizations & group practices 4

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

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1861600116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "484-628-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S 5TH AVE",
            "city": "WEST READING",
            "state": "PA",
            "postal_code": "196112143",
            "telephone_number": "484-628-5455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6th Avenue & Spruce Street",
            "address_purpose": "LOCATION",
            "city": "West Reading",
            "state": "PA",
            "postal_code": "19611",
            "country_code": "US",
            "telephone_number": "610-988-8446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAGOLU",
        "first_name": "PAVANI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD434770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102396494",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Reading, PA

Sources for this page

Verify at the official NPI Registry.