VITHAL KUSUMA M.D.
NPI 1750375051
Internal Medicine - Gastroenterology in Cordele, GA
NPI Status: Active since September 01, 2005
- Individual
- Male
- Years of Experience 57
- Internal Medicine
- Gastroenterology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About VITHAL KUSUMA
This page provides the complete NPI Profile along with additional information for Vithal Kusuma, an internist established in Cordele, Georgia with a medical specialization in Internal Medicine, focusing in gastroenterology and more than 57 years of experience. The healthcare provider is registered in the NPI registry with number 1750375051 assigned on September 2005. The practitioner's primary taxonomy code is 207RG0100X with license number 021536 (GA). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1750375051
- Provider Name
- VITHAL KUSUMA M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 902 N 7TH ST CORDELE, GA 31015
- Location Phone
- (229) 276-3100
- Mailing Address
- 1009 N MONROE ST ALBANY, GA 31701
- Mailing Phone
- (229) 883-0298
- Medical School Name
- OTHER
- Graduation Year
- 1969
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-01-2005
- Last Update Date
- 01-25-2021
- Code Navigator
An internist like Vithal Kusuma is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Secondary Locations
- 1009 N Monroe St
Albany, GA 31701
(229) 883-0298
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Gastroenterology
- Taxonomy Code
- 207RG0100X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 021536
- License State
- GA
- Taxonomy Description
- An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- SoloCare Bronze EPO HDHP 8050 10004 - EPO
- SoloCare Exp Bronze EPO 7200 - $0 Generic Rx 10015 - EPO
- SoloCare Gold EPO 2300 - 3 Free PCP Visits, $5 Generic Rx 10010 - EPO
- SoloCare Silver EPO 6000/60 - 3 Free PCP Visits 10014 - EPO
- SoloCare Silver EPO 7000 - 3 Free PCP Visits, $5 Generic Rx 10013 - EPO
- SoloCare Standard Exp Bronze EPO 10008 - EPO
- SoloCare Standard Gold EPO 10006 - EPO
- SoloCare Standard Platinum EPO 10005 - EPO
- SoloCare Standard Silver EPO 10007 - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Vithal Kusuma is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Vithal Kusuma is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 9436053774
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20090122000674
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Upper gastrointestinal (GI) endoscopy for acid reflux
An upper GI endoscopy is a procedure to examine your esophagus and stomach using a thin, flexible tube called an endoscope. It helps diagnose conditions like acid reflux by identifying any inflammation or damage. It's generally safe, performed under sedation, and takes about 15-30 minutes.
This service was performed for 12 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $31.02 for a new patient copayment and $23.71 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 31015 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $124.1
- Minimum New Patient Price $53.31
- Maximum New Patient Price $164.04
- Average New Patient Copayment $31.02
- Minimum New Patient Copayment $13.32
- Maximum New Patient Copayment $41.01
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $94.84
- Minimum Established Patient Price $16.68
- Maximum Established Patient Price $133.24
- Average Established Patient Copayment $23.71
- Minimum Established Patient Copayment $4.17
- Maximum Established Patient Copayment $33.31
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Vithal Kusuma is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
COLISEUM MEDICAL CENTERS, LLC, DBA | 350 HOSPITAL DRIVE MACON, GA 31217 | (478) 765-7000 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 7 | 5 | 0 | 3 | 7 | 5 | 0 | 5 | 1 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 7 | 10 | 0 | 6 | 7 | 10 | 0 | 10 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 7 + 1 + 0 + 0 + 6 + 7 + 1 + 0 + 0 + 1 + 0 + 24 = 49 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
50 - 49 = 1 | 1 |
The NPI number 1750375051 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1053396739 | DEBORAH J CHARLES MD Individual | Radiology (Diagnostic Radiology) | 902 N 7TH ST CORDELE, GA 31015 (229) 276-3356 |
1174596068 | KENNETH W WATSON CRNA Individual | Nurse Anesthetist, Certified Registered | 902 N 7TH ST CORDELE, GA 31015 (229) 276-3100 |
1609843069 | DALE M LAWSON MD Individual | Emergency Medicine | 902 N 7TH ST CORDELE, GA 31015 (229) 276-3200 |
1457329377 | CRISP REGIONAL HOSPITAL, INC Organization | Clinic/Center (End-Stage Renal Disease (ESRD) Treatment) | 902 N 7TH ST CORDELE, GA 31015 (229) 276-3100 |
1588628309 | CHRISTY JANE CLARY PHARM.D. Individual | Pharmacist | 902 N 7TH ST CORDELE, GA 31015 (229) 276-3384 |
1821100892 | GA CELL AND TISSUE DIAGNOSTIC CENTER INC. Organization | Clinical Medical Laboratory | 902 N 7TH ST CORDELE, GA 31015 (229) 276-3342 |
1043413271 | HARRY S. LATHAM M.D. Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 902 N 7TH ST CORDELE, GA 31015 (229) 276-3342 |
1790983815 | MRS. KELLEY GRANADE KICHLER RD, LD, CNSD Individual | Dietitian, Registered | 902 N 7TH ST CORDELE, GA 31015 (229) 276-3375 |
1982802005 | LAURA ANNE MIHALOVIC RD, LD, CNSD Individual | Dietitian, Registered | 902 N 7TH ST CORDELE, GA 31015 (229) 276-3375 |
1457633885 | MISS FEAI VOON WONG MS, RD, LD Individual | Dietitian, Registered | 902 N 7TH ST CORDELE, GA 31015 (229) 276-3375 |
1255514584 | DR. JEREMY HILL MD Individual | Radiology (Diagnostic Radiology) | 902 N 7TH ST CORDELE, GA 31015 (229) 276-3348 |
1578669602 | MARILYN Y. CARTER MD Individual | Internal Medicine | 902 N 7TH ST CORDELE, GA 31015 (229) 276-3100 |
1265424998 | MR. JAMIE MICHAEL ATKINS CRNA Individual | Nurse Anesthetist, Certified Registered | 902 N 7TH ST CORDELE, GA 31015 (912) 294-6237 |
1750714010 | MRS. KIMBERLY K HICKS RD, LD Individual | Dietitian, Registered | 902 N 7TH ST CORDELE, GA 31015 (229) 276-3375 |
1669807202 | CRH VEIN CENTER, LLC Organization | Anesthesiology | 902 N 7TH ST CORDELE, GA 31015 (229) 276-3600 |
1528025426 | MR. JOHN PAUL HAMILTON MS, ATC, LAT Individual | Specialist/Technologist (Athletic Trainer) | 902 N 7TH ST CORDELE, GA 31015 (407) 398-4962 |
1194129924 | CRISP REGIONAL HOSPITAL PHARMACY Organization | General Acute Care Hospital | 902 N 7TH ST CORDELE, GA 31015 (229) 276-3386 |
1013489871 | MRS. EMILY SELPH KING MS, RD, LD Individual | Dietitian, Registered | 902 N 7TH ST CORDELE, GA 31015 (229) 276-3375 |
1538793724 | MRS. CORLYNDA JO BLOODWORTH MSN, FNP-C Individual | Nurse Practitioner (Family) | 902 N 7TH ST CORDELE, GA 31015 (229) 276-3315 |
1073125159 | DEANNA MATHIS THOMPSON NP-C Individual | Nurse Practitioner (Family) | 902 N 7TH ST CORDELE, GA 31015 (229) 276-3100 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1750375051, enumerated in the NPI registry as an "individual" on September 01, 2005
The provider is located at 902 N 7th St Cordele, Ga 31015 and the phone number is (229) 276-3100
The provider's speciality is Internal Medicine with taxonomy code 207RG0100X with a focus in Gastroenterology
The provider has more than 57 years of experience.
The provider might be accepting Accepts: Alliant Health Plans, Inc.. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $124.1 with an average copayment of $31.02 for new patient appointments. Established patients should expect a typical charge of $94.84 and an average copayment of 23.71. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Upper gastrointestinal (GI) endoscopy for acid reflux.
The practitioner is affiliated to the following hospital(s): COLISEUM MEDICAL CENTERS, LLC, DBA. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on September 01, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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