NPIMap

Individual provider Active NPI

Pravardhan Rajashekar Birthi, M.D.

  • Interventional Pain Medicine Physician
  • Grand Island, NE
National Provider Identifier
1013161082
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
27075 Issued in NE
Practice address
403 Lexington Cir
Grand Island, NE 68803-9728
Phone
(308) 675-3222
Fax
(308) 675-3234
NPI assigned
Nov 4, 2008
Last updated
Jun 21, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 27075 NE Primary

Addresses

Primary practice location

403 Lexington Cir
Grand Island, NE 68803-9728

Mailing address

403 Lexington Cir
Grand Island, NE 68803-9728
Phone (308) 675-3222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130829000071 NE Practitioner - Pain Management 4385887926 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Howard County Medical CenterGroup PAC ID 5698775849, 28 clinicians
Grand Island Pain Relief Center PCGroup PAC ID 7416282868, 6 clinicians

Practice addresses (Care Compare)

1113 Sherman St
Saint Paul, NE 68873-1546
Phone (308) 754-4421

403 Lexington Cir
Grand Island, NE 68803-9728
Phone (308) 675-3222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27075NEMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brodstone Memorial Hospital CurrentSince Oct 1, 2020 Accepting new patients
Thayer County Memorial Hospital CurrentSince Mar 1, 2022 Accepting new patients
Howard County Medical Center CurrentSince Apr 1, 2019 Accepting new patients
Go Physical Therapy, LLC CurrentSince Jul 1, 2019 Accepting new patients
Kearney Co Health Services CurrentSince Nov 9, 2020 Accepting new patients
Howard County Medical Center CurrentSince Apr 1, 2019 Accepting new patients
Brodstone Memorial Hospital Current Accepting new patients
Thayer County Memorial Hospital CurrentSince Mar 1, 2022 Accepting new patients
Kearney Co Health Services Current Accepting new patients
Brodstone Memorial Hospital CurrentSince Oct 1, 2020 Accepting new patients
Kearney Co Health Services CurrentSince Nov 9, 2020 Accepting new patients
Crane River TMS Clinic LLC PastSince May 1, 2024 Accepting new patients
Brodstone Memorial Hospital Past Accepting new patients
Lincoln Physician Network LLC Past Accepting new patients
Howard County Medical Center Past Accepting new patients

Locations

2620 W Faidley Ave
Grand Island, NE 68803
Phone (308) 382-6856

726 Eastside Blvd
Hastings, NE 68901
Phone (402) 463-2085

120 Park Ave
Hebron, NE 68370
Phone (402) 768-6041

727 E 1st St
Minden, NE 68959
Phone (308) 832-1440

1113 Sherman St
Saint Paul, NE 68873
Phone (308) 754-4421

520 E 10th St
Superior, NE 68978
Phone (402) 224-3344

Networks

  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
  • IA HMO C-SNP
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • CO HMO
  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
  • CO HMO D-SNP
  • IA HMO

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/392964be-b711-4e7a-a97d-b35e931678a8/
  • FHIR API: https://fhir-myrecord.cerner.com/r4/a4c7307b-5132-41db-ae59-8b3c5b480948/
  • FHIR API: https://fhir-myrecord.cerner.com/r4/afb10dcd-fcfe-4394-bcee-f9c44a02df40/
  • Direct secure messaging: pravardhan.birthi.2@19476.direct.athenahealth.com

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 16

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1013161082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 LEXINGTON CIR",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688039728",
            "telephone_number": "308-675-3222",
            "fax_number": "308-675-3234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 LEXINGTON CIR",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688039728",
            "telephone_number": "308-675-3222",
            "fax_number": "308-675-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRTHI",
        "first_name": "PRAVARDHAN",
        "middle_name": "RAJASHEKAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-04",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NE",
            "license": "27075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.