Individual provider Active NPI

Nandan Prasad

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1063807048
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD464382 Issued in PA
Practice address
1020 Sansom St Ste 239
Philadelphia, PA 19107-5002
Phone
(215) 955-6844
Fax
(215) 955-2526
NPI assigned
Apr 6, 2015
Last updated
Apr 2, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X MD464382 PA Primary

Addresses

Primary practice location

1020 Sansom St Ste 239
Philadelphia, PA 19107-5002

Mailing address

111 S 11TH St
Philadelphia, PA 19107-4824
Phone (215) 955-9837

Other practice location 1

2021 Chestnut St
Philadelphia, PA 19103-3373
Phone (267) 443-2020

Other practice location 2

700 Walnut St
Philadelphia, PA 19106-3505
Phone (215) 503-7300

Other practice location 3

2301 N Broad St Ste 1
Philadelphia, PA 19132-4526
Phone (215) 952-9136

Other practice location 4

2607 Rhawn St
Philadelphia, PA 19152-3038
Phone (215) 333-0304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, CA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20190425000800 PA Practitioner - Emergency Medicine 7012237605 Reassigns benefits to 1 organization
I20191230000118 CA Practitioner - Emergency Medicine 7012237605 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Missouri, Columbia School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Team Physicians of Southern California Medical Group IncGroup PAC ID 0446545354, 21 clinicians

Practice addresses (Care Compare)

4002 Vista Way
Oceanside, CA 92056-4506
Phone (760) 724-8411

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Acute Care Physicians, PC CurrentSince Mar 4, 2019 Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince Mar 4, 2019 Accepting new patients

Locations

700 Walnut St
Philadelphia, PA 19106
Phone (215) 503-7300

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1063807048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-9837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 SANSOM ST STE 239",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075002",
            "telephone_number": "215-955-6844",
            "fax_number": "215-955-2526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2021 Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191033373",
            "country_code": "US",
            "telephone_number": "267-443-2020",
            "fax_number": "215-640-8860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Walnut St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191063505",
            "country_code": "US",
            "telephone_number": "215-503-7300",
            "fax_number": "215-503-5666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2301 N Broad St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191324526",
            "country_code": "US",
            "telephone_number": "215-952-9136",
            "fax_number": "215-952-9138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2607 Rhawn St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191523038",
            "country_code": "US",
            "telephone_number": "215-333-0304",
            "fax_number": "215-333-1402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRASAD",
        "first_name": "NANDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-06",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD464382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.