Pavankumar Bommasamudram, M.D.
Pavankumar Bommasamudram, M.D. is an Internal Medicine Physician in Tulsa, OK, registered under NPI 1639306293.
Getting there
The practice address on file is 1705 E 19TH ST STE #302, Tulsa, OK 74104. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 27309 | OK | Internal Medicine Physician primary |
| 04-41542 | KS | Internal Medicine Physician |
Licences are recorded in 2 states: OK, KS. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - Internal Medicine
- PAC ID
- 3779749478
Enrolled in Medicare 10 times, across 10 states:
| State | Enrollment ID | Provider type |
|---|---|---|
| Oklahoma | I20120725000093 | Practitioner - Internal Medicine |
| West Virginia | I20180821001219 | Practitioner - Internal Medicine |
| Oregon | I20180925001867 | Practitioner - Internal Medicine |
| Kansas | I20181213001312 | Practitioner - Internal Medicine |
| Texas | I20190617000508 | Practitioner - Hospitalist |
| Arkansas | I20210405000178 | Practitioner - Internal Medicine |
| Iowa | I20230622001945 | Practitioner - Internal Medicine |
| Nebraska | I20240126000209 | Practitioner - Internal Medicine |
| Indiana | I20240914000436 | Practitioner - Neurology |
| Missouri | I20260316003833 | Practitioner - Internal Medicine |
Medicare enrolment is recorded as approved under the provider type Practitioner - Internal Medicine. There are 10 separate enrolment records across 10 states (OK, WV, OR, KS, TX, AR, IA, NE, IN, MO). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 2 states
This provider holds licences in 2 states: Kansas and Oklahoma. The practice address on file is in Tulsa, OK, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
- Licence
- 27309
- Specialty
- Internal Medicine Physician
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Internal Medicine covers
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. NUCC Health Care Provider Taxonomy, code 207R00000X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 207R00000X | Internal Medicine Physician | 27309 | OK | primary |
| 207R00000X | Internal Medicine Physician | 04-41542 | KS |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1639306293 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Jun 22, 2009 |
| Last updated | Dec 5, 2018 |
| Status | Active |
| Sole proprietor | No |
| Gender | Male |
| Credential | M.D. |
| Practice address |
1705 E 19TH ST STE #302 Tulsa, OK 74104 (918) 748-7585 Fax (918) 748-7539 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 6 | 3 | 9 | 3 | 0 | 6 | 2 | 9 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 6 | 6 | 9 | 6 | 0 | 3 | 2 | 9 |
Sum = 67 · next multiple of 10 = 70 · check digit = 3 · actual last digit = 3
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.