DR. PAVAN KUMAR MAMILLA (M.D) – Family Medicine Physician, NPI 1417188103
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,102 FAMILY PRACTICE in GA
Provider Addresses for DR. PAVAN KUMAR MAMILLA (M.D)
11379 SOUTHBRIDGE PKWY STE A
ALPHARETTA, GA 300224402
Phone: (770) 777-0750
Fax: (770) 777-0521
Type: Mailing
Medical Center Parkway, Selma, Dallas County, Alabama, 36701, United States
SUITE 200
SELMA, AL 367016780
Phone: (334) 875-4184
Fax: (334) 874-3511
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 71 Open Payments records for all available years, with a total value of $1,396.
Total Amount is formed as General ($1,396) + Research ($0) + Ownership ($0) = $1,396.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($219).
Total Amount
$1,396
General + Research + Ownership
Payments
71
Total payment records
General Amount
$1,396
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-13
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-05-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20141007001725 | I | Family Practice | AL | TBD |
| I20180523002377 | I | Family Practice | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 210 | 80 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 104 | 50 | $0 |
| 81002 | Urinalysis, manual test | 74 | 59 | $0 |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | 50 | 50 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 46 | 46 | $0 |
Insurance plans in this area (ZIP 30022)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | AL | |
| Family Practice | AL | |
| - | GA |
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