Swapna Madhavan, MD - Medicare Family Practice in Cumming, GA

Swapna Madhavan, MD is a medicare enrolled "Family Medicine" physician in Cumming, Georgia. She graduated from medical school in 1998 and has 26 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Georgia Highlands Medical Services, Inc. and her current practice location is 260 Elm St, Cumming, Georgia. You can reach out to her office (for appointments etc.) via phone at (770) 887-1668.

Swapna Madhavan is licensed to practice in Georgia (license number 057098) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1205880309.

Contact Information

Swapna Madhavan, MD
260 Elm St,
Cumming, GA 30040-2467
(770) 887-1668
(779) 781-9937

Map and Direction




Physician's Profile

Full NameSwapna Madhavan
GenderFemale
SpecialityFamily Practice
Experience26 Years
Location260 Elm St, Cumming, Georgia
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Swapna Madhavan graduated from medical school in 1998
  NPI Data:
  • NPI Number: 1205880309
  • Provider Enumeration Date: 05/22/2006
  • Last Update Date: 03/07/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 1557373958
  • Enrollment ID: I20060630000073

Medical Identifiers

Medical identifiers for Swapna Madhavan such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1205880309NPI-NPPES
983802OtherGABLUE CORSS/BLUE SHIELD #
057098OtherGAGA MEDICAL LICENSE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 057098 (Georgia)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Northside Hospital ForsythCumming, GAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Georgia Highlands Medical Services, Inc.58906820179

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. Swapna Madhavan allows following entities to bill medicare on her behalf.
Entity NameGeorgia Highlands Medical Services, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1174529192
PECOS PAC ID: 5890682017
Enrollment ID: O20040302001307

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. Swapna Madhavan 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 AddressPractice Location Address
Swapna Madhavan, MD
Po Box 307,
Cumming, GA 30028-0307

Ph: (770) 887-1668
Swapna Madhavan, MD
260 Elm St,
Cumming, GA 30040-2467

Ph: (770) 887-1668

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

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