Pankaj Agrawal, MBBS
Individual provider Active NPI Adult Medicine Physician · Marshalltown, IA
NPI 1861706038 · NPPES record last updated Jul 8, 2013
Key facts
- NPI
- 1861706038
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Medicine Physician 207QA0505X
- License
- 40719 (IA)
- Practice address
- 3 S 4TH Ave
Marshalltown Medical & Surgical Cent
Marshalltown, IA 50158-2924 - Phone
- (641) 754-5151
- NPI assigned
- Jul 30, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 9
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Hospitalist
- Education
- Other, 2007
- Medicare assignment
- May accept Medicare assignment
- Group practices
- South Georgia Medical Center Inc
Apogee Medical Group Georgia
Practice addresses (Care Compare)
2501 N Patterson St
Valdosta, GA 31602-1735
Phone (229) 433-1000
Hospital & facility affiliations
- SGMC Health
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.29 of 100
- Quality
- 70.79
- Improvement activities
- 40
- Cost
- 81.32
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170208002373 | GA | Practitioner - Hospitalist |
3274776083 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40719 | IA | MD | Adult Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apogee Medical Group Georgia | Current |
Accepting new patients | |
| South Georgia Medical Center Inc | Current |
Accepting new patients | |
| South Georgia Medical Center Inc | Current | Accepting new patients | |
| South Georgia Medical Center Inc | Current |
Accepting new patients | |
| Hospital Authority of Valdosta and Lowndes County Georgia | Past | Accepting new patients |
Locations
15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601
705 Dixie St
Carrollton, GA 30117
Phone (770) 812-9666
915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575
2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139
604 E Park Ave
Valdosta, GA 31602
Phone (229) 333-0277
601 Dallas Hwy
Villa Rica, GA 30180
Phone (770) 456-3000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | 40719 | IA | Yes |
Addresses
Primary practice location
3 S 4TH Ave
Marshalltown Medical & Surgical Cent
Marshalltown, IA 50158-2924
Mailing address
3 S 4TH Ave
Marshalltown Medical & Surgical Cent
Marshalltown, IA 50158-2924
Phone (641) 754-5151
Other providers in Marshalltown, IA
- 13TH Street Chiropractic LLC
- Abilit Holdings (Glenwood Place) LLC
- Accura Healthcare of Marshalltown LLC
- Melody Dawn Adelmund
- Julieta Aguilera-Perez
- Align Wellness LLC
- American Homepatient, Inc.
- Brooklyn Ann Marie Amundson
- Beth Ann Andrew
All providers in Marshalltown, IA · Adult Medicine Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.