Individual provider Active NPI

Ganga Prabhakar, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Des Moines, IA
National Provider Identifier
1023109444
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
19367 Issued in WV
Practice address
411 Laurel St
Suite 250
Des Moines, IA 50314-3017
Phone
(515) 235-5000
Fax
(515) 288-6713
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 036148898 IL
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 19367 WV Primary

Addresses

Primary practice location

411 Laurel St
Suite 250
Des Moines, IA 50314-3017

Mailing address

5880 University Ave
West Des Moines, IA 50266-8209
Phone (515) 633-3835

Other practice location 1

409 W Oak St Ste 202
Carbondale, IL 62901-1464
Phone (618) 529-0555

Other identifiers 1

IdentifierTypeStateIssuer
1804141000MedicaidWV

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address gprabhakar237233@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address gprabhakar237233@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, WI, IL3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040615001894 WV Practitioner - Cardiac SurgeryPractitioner - Thoracic Surgery 6709860943 Reassigns benefits to 2 organizations
I20191025000303 WI Practitioner - Thoracic Surgery 6709860943 Reassigns benefits to 1 organization
I20200130002235 IL Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 6709860943 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Thoracic Surgery
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wheeling Hospital IncGroup PAC ID 5799689493, 433 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Morgantown, WV 26506-1200
Phone (304) 598-4865

10 Medical Park
Suite 104
Wheeling, WV 26003-6389
Phone (304) 242-4800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation CurrentSince Oct 4, 2019 Accepting new patients
Wheeling Hospital Inc Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Feb 1, 2021 Accepting new patients
Mercy Health System Corporation CurrentSince Oct 4, 2019 Accepting new patients
Mercy Health System Corporation Current Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Feb 19, 2020 Accepting new patients
West Virginia University Medical Corporation CurrentSince Oct 12, 2020 Accepting new patients
West Virginia University Medical Corporation CurrentSince Oct 12, 2020 Accepting new patients
Rockford Health Physicians CurrentSince May 15, 2020 Accepting new patients
Boone County Hospital Past Accepting new patients
Iowa Heart Center PC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients
Wheeling Hospital Inc Past Accepting new patients
Morgantown Pulmonary Associates PC Past Accepting new patients

Locations

409 W Oak St
Ste 202
Carbondale, IL 62901
Phone (618) 295-0555

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

2350 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-2200

8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

300 Davisson Run Rd
Clarksburg, WV 26301
Phone (304) 624-2121

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

1200 J D Anderson Dr
Morgantown, WV 26505
Phone (304) 598-1460

1265 Pineview Dr
Morgantown, WV 26505
Phone (304) 598-1265

705 Garfield Ave
Ste 440
Parkersburg, WV 26101
Phone (304) 424-2098

1 Medical Park
Wheeling, WV 26003
Phone (304) 243-3124

10 Medical Park
Ste 104
Wheeling, WV 26003
Phone (304) 242-4800

10 Medical Park
Ste 300
Wheeling, WV 26003
Phone (304) 242-3900

20 Medical Park
Ste 105
Wheeling, WV 26003
Phone (304) 242-4800

Organizations & group practices 13

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

View all 13

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1023109444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5880 UNIVERSITY AVE",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668209",
            "telephone_number": "515-633-3835",
            "fax_number": "515-633-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 LAUREL ST",
            "address_2": "SUITE 250",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143017",
            "telephone_number": "515-235-5000",
            "fax_number": "515-288-6713"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "409 W Oak St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011464",
            "country_code": "US",
            "telephone_number": "618-529-0555",
            "fax_number": "618-529-0556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRABHAKAR",
        "first_name": "GANGA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IL",
            "license": "036148898",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WV",
            "license": "19367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1804141000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gprabhakar237233@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10 Medical Park",
            "city": "Wheeling",
            "state": "WV",
            "country_code": "US",
            "postal_code": "260036389",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gprabhakar237233@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10 Medical Park",
            "city": "Wheeling",
            "state": "WV",
            "country_code": "US",
            "postal_code": "260036389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.