DR. SUMITH RAO MADHAVARAPU D.O.
NPI 1891052825
Pediatrics in Houston, TX
NPI Status: Active since April 16, 2012
- Individual
- Male
- Pediatrics
- Accepts Insurance
- PECOS Enrolled
About SUMITH MADHAVARAPU
This page provides the complete NPI Profile along with additional information for Sumith Madhavarapu, a pediatrician established in Houston, Texas with a medical specialization in Pediatrics. The healthcare provider is registered in the NPI registry with number 1891052825 assigned on April 2012. The practitioner's primary taxonomy code is 208000000X with license number R7266 (TX). The provider is registered as an individual and his NPI record was last updated 5 years ago.
- NPI
- 1891052825
- Provider Name
- DR. SUMITH RAO MADHAVARAPU D.O.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 921 GESSNER RD HOUSTON, TX 77024
- Location Phone
- (713) 242-3000
- Mailing Address
- 1317 ISABELLA ST HOUSTON, TX 77004
- Mailing Phone
- (405) 474-0683
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 04-16-2012
- Last Update Date
- 07-29-2020
- Code Navigator
A pediatrician like Sumith Madhavarapu is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
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
Pediatrics
- Taxonomy Code
- 208000000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- R7266
- License State
- TX
- Taxonomy Description
- A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | 54230 (CT) |
| 2 | 2080S0012X | Allopathic & Osteopathic Physicians | Pediatrics | R7266 (TX) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Choice Bronze HSA (QualChoice) - POS
- Complete Gold - PPO
- Complete Gold + Vision + Adult Dental - PPO
- Complete Silver (QualChoice) - POS
- Connected Silver - PPO
- Connected Silver (QualChoice) - POS
- Connected Silver (QualChoiceLife) - PPO
- Connected Silver + Vision + Adult Dental - PPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Clear VALUE Silver - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Complete VALUE Gold - HMO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Complete VALUE Gold - HMO
- Complete VALUE Silver - HMO
- Elite VALUE Bronze - HMO
- Focused VALUE Silver - HMO
- Standard Expanded Bronze VALUE - HMO
- Standard Gold VALUE - HMO
- Standard Silver VALUE - HMO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Elite Gold - PPO
- Elite Gold + Vision + Adult Dental - PPO
- Everyday Bronze - PPO
- Everyday Bronze + Vision + Adult Dental - PPO
- Everyday Gold - PPO
- Everyday Gold + Vision + Adult Dental - PPO
- Focused Silver - PPO
- Focused Silver + Vision + Adult Dental - PPO
- Community Premier Bronze 003 (No deductible for PCP, Free Preventive Care, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Premier Bronze 018 (No deductible for PCP, Specialists & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Premier Gold 005 (No Deductible for PCP, Specialists & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Premier Gold 021 (No Deductible for PCP, Specialists & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Premier Silver 012 (No deductible for PCP, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Premier Silver 020 (No Deductible for PCP, Specialists & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Select Bronze 016 (No deductible for PCP & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Select Gold 022 (No Deductible for PCP, Specialists & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Community Select Silver 019 (No Deductible for PCP, Specialists & Generics, $0 PCP 24/7 Virtual Care Options) - HMO
- Wellpoint Essential Bronze 4000 HSA ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 6000 Adult Dental/Vision ($0 Virtual PCP+$0 Select Drugs) - HMO
- Wellpoint Essential Bronze 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze POS 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Bronze POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Bronze POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Catastrophic 9200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 1500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 1500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Sumith Madhavarapu 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
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
Physician Visit Costs
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 77024 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $90.4
- Minimum New Patient Price $58.24
- Maximum New Patient Price $176.98
- Average New Patient Copayment $22.6
- Minimum New Patient Copayment $14.56
- Maximum New Patient Copayment $44.24
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $102.71
- Minimum Established Patient Price $18.6
- Maximum Established Patient Price $143.93
- Average Established Patient Copayment $25.67
- Minimum Established Patient Copayment $4.65
- Maximum Established Patient Copayment $35.98
* 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.
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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 | 8 | 9 | 1 | 0 | 5 | 2 | 8 | 2 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 18 | 1 | 0 | 5 | 4 | 8 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 1 + 8 + 1 + 0 + 5 + 4 + 8 + 4 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1891052825 is valid because the calculated check digit 5 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 |
|---|---|---|---|
| 1487652806 | CHRISTINE M MORRISON CRNA Individual | Nurse Anesthetist, Certified Registered | 921 GESSNER RD HOUSTON, TX 77024 (713) 242-3439 |
| 1518941228 | SHELLY K. BROLINE MD PA Organization | Nuclear Medicine | 921 GESSNER RD HOUSTON, TX 77024 (713) 432-1100 |
| 1396705398 | ANDREA MARCONI D.O, M.D Individual | Emergency Medicine | 921 GESSNER RD HOUSTON, TX 77024 (713) 242-3070 |
| 1992730246 | MEMORIAL CITY EMERGENCY PHYSICIANS, LLP Organization | Emergency Medicine | 921 GESSNER RD HOUSTON, TX 77024 (713) 242-3000 |
| 1558387407 | MICHAEL CANTU M.D. Individual | Emergency Medicine | 921 GESSNER RD HOUSTON, TX 77024 (713) 242-3000 |
| 1396761235 | KELLY BAKER P.A.-C Individual | Physician Assistant | 921 GESSNER RD HOUSTON, TX 77024 (713) 242-3000 |
| 1174549026 | KATHERINE HEALEY M.D. Individual | Emergency Medicine | 921 GESSNER RD HOUSTON, TX 77024 (713) 456-5000 |
| 1417974965 | NIKA ELIZABETH BRUSATORI M.D. Individual | Emergency Medicine | 921 GESSNER RD MEMORIAL HERMAN MEMORIAL CITY EMERGENCY ROOM HOUSTON, TX 77024 (713) 242-3070 |
| 1306863840 | WILLIAM EDWARDS M.D. Individual | Emergency Medicine | 921 GESSNER RD HOUSTON, TX 77024 (713) 242-3000 |
| 1720093388 | GEORGE K HANSON, MD Organization | Anesthesiology | 921 GESSNER RD HOUSTON, TX 77024 (281) 880-6991 |
| 1265447825 | SCOTT W. DUNCAN, MD Organization | Anesthesiology | 921 GESSNER RD HOUSTON, TX 77024 (281) 880-6991 |
| 1528073186 | CURTIS DAVID WARRINGTON MD PA Organization | Anesthesiology | 921 GESSNER RD HOUSTON, TX 77024 (281) 880-6991 |
| 1366549149 | EMMA MORRIS RN, MS, FNP Individual | Nurse Practitioner | 921 GESSNER RD HOUSTON, TX 77024 (713) 456-5000 |
| 1619074499 | SHARITA ELIZABETH WARFIELD M.D. Individual | Emergency Medicine | 921 GESSNER RD HOUSTON, TX 77024 (713) 242-3000 |
| 1679651210 | MARK GOLDSTEIN MD Individual | Anesthesiology | 921 GESSNER RD ATTN: ANESTHESIA DEPT HOUSTON, TX 77024 (713) 932-3019 |
| 1477622058 | ANITA GIEZENTANNER MD Individual | Anesthesiology | 921 GESSNER RD ANESTHESIA DEPT HOUSTON, TX 77024 (713) 932-3019 |
| 1538227079 | HOSNI R BASSILI MD Individual | Anesthesiology | 921 GESSNER RD SUITE #226 HOUSTON, TX 77024 (713) 242-3439 |
| 1437215449 | METROWEST ANESTHESIA CARE, PLLC Organization | Anesthesiology | 921 GESSNER RD ATTN ANESTHESIA DEPT HOUSTON, TX 77024 (713) 464-9621 |
| 1710172549 | DOUGLAS J. HIRSCH, MD, PA Organization | Anesthesiology | 921 GESSNER RD HOUSTON, TX 77024 (713) 932-3019 |
| 1093996803 | JEROME R ELK, MD Organization | Anesthesiology | 921 GESSNER RD HOUSTON, TX 77024 (713) 932-3019 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1891052825, enumerated in the NPI registry as an "individual" on April 16, 2012
The provider is located at 921 Gessner Rd Houston, Tx 77024 and the phone number is (713) 242-3000
The provider's speciality is Pediatrics with taxonomy code 208000000X
The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. 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 $90.4 with an average copayment of $22.6 for new patient appointments. Established patients should expect a typical charge of $102.71 and an average copayment of 25.67. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on April 16, 2012. 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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