Pavan Kolluri, MD in South Windsor, CT - Medicare Emergency Medicine

Pavan Kolluri, MD is a medicare enrolled "Emergency Medicine" physician in South Windsor, Connecticut. He went to University Of Missouri, Kansas City, School Of Medicine and graduated in 1998 and has 26 years of diverse experience with area of expertise as Emergency Medicine. He is a member of the group practice West Fairview Emergency Physicians Llc and his current practice location is 204 Talcott Ridge Rd, South Windsor, Connecticut. You can reach out to his office (for appointments etc.) via phone at (860) 648-4032.

Pavan Kolluri is licensed to practice in Kentucky (license number 36831) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1477586428.

Contact Information

	Pavan Kolluri, MD
	204 Talcott Ridge Rd, South Windsor, CT 06074-2394
	(860) 648-4032
	(260) 407-8004

Map and Direction

Physician's Profile

Full Name	Pavan Kolluri
Gender	Male
Speciality	Emergency Medicine
Experience	26 Years
Location	204 Talcott Ridge Rd, South Windsor, Connecticut
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Pavan Kolluri attended and graduated from University Of Missouri, Kansas City, School Of Medicine in 1998

NPI Data:

NPI Number: 1477586428
Provider Enumeration Date: 07/09/2006
Last Update Date: 10/15/2008

Medicare PECOS Information:

PECOS PAC ID: 3173661949
Enrollment ID: I20091116000414

Medical Identifiers

Medical identifiers for Pavan Kolluri such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1477586428	NPI	-	NPPES
64036676	Medicaid	KY
930109200	Other	KY	RAILROAD

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207P00000X	Emergency Medicine	36831 (Kentucky)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
King's Daughters' Medical Center	Ashland, KY	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
West Fairview Emergency Physicians Llc	5799034799	7

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Pavan Kolluri allows following entities to bill medicare on his behalf.

Entity Name	West Fairview Emergency Physicians Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1578060331 PECOS PAC ID: 5799034799 Enrollment ID: O20180824000999

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Pavan Kolluri is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Pavan Kolluri, MD 204 Talcott Ridge Rd, South Windsor, CT 06074-2394 Ph: (860) 648-4032	Pavan Kolluri, MD 204 Talcott Ridge Rd, South Windsor, CT 06074-2394 Ph: (860) 648-4032

Pavan Kolluri, MD - Medicare Emergency Medicine in South Windsor, CT