Individual provider Active NPI

Prathab Devaraj, MD

  • Internal Medicine Physician
  • Gilbert, AZ
National Provider Identifier
1073778064
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
46888 Issued in AZ
Practice address
2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165
Phone
(480) 256-6444
Fax
(480) 256-3682
NPI assigned
Jul 19, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD443519 PA
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X 46888 AZ
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 46888 AZ Primary

Addresses

Primary practice location

2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165

Mailing address

2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165
Phone (480) 256-6444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130124000528 AZ Practitioner - GastroenterologyPractitioner - Internal Medicine 0446421929 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1920 N Higley Rd
Suite 308
Gilbert, AZ 85234-1625
Phone (480) 543-6600

2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165
Phone (480) 256-6444

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.42 of 100Reported as group
Quality
62.19
Promoting interoperability
99
Improvement activities
40
Cost
61.29

Merit-based Incentive Payment System (MIPS)

Final score
84.12 of 100Reported as group
Quality
76.35
Promoting interoperability
99
Improvement activities
40
Cost
71.55

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy160
Upper gastrointestinal (GI) endoscopy for acid reflux438

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46888AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Cancer Center Specialists LLC Multi-Specialty CurrentSince Jul 1, 2017 Accepting new patients
Banner Cancer Center Specialists LLC Multi-Specialty CurrentSince Jul 1, 2017 Accepting new patients
Banner Physician Specialists Arizona LLC Multi-Specialty CurrentSince Oct 18, 2017 Accepting new patients
Banner Physician Specialists Arizona LLC Multi-Specialty Current Accepting new patients
Banner Physician Specialists Arizona LLC Multi-Specialty CurrentSince Oct 18, 2017 Accepting new patients
Hospitalist Medicine Physicians of Pennsylvania, P.C. Multi-Specialty Past Accepting new patients
Hospitalist Medicine Physicians of Washington County, LLC Multi-Specialty Past Accepting new patients

Locations

1405 S Alma School Rd
Chandler, AZ 85286
Phone (480) 256-7000

1125 S Alma School Rd
Ste 210
Chandler, AZ 85286
Phone (480) 256-4900

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

2946 E Banner Gateway Dr
Rm 2008
Gilbert, AZ 85234
Phone (480) 256-4523

2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone (480) 256-5450

1920 N Higley Rd
Ste 308
Gilbert, AZ 85234
Phone (480) 543-6600

1400 S Dobson Rd
Ste A100
Mesa, AZ 85202

1400 S Dobson Rd
Ste 100
Mesa, AZ 85202

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

925 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-4498

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

1625 N Campbell Ave
Tucson, AZ 85719

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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": "1216425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1073778064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2946 E BANNER GATEWAY DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342165",
            "telephone_number": "480-256-6444",
            "fax_number": "480-256-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2946 E BANNER GATEWAY DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342165",
            "telephone_number": "480-256-6444",
            "fax_number": "480-256-3682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVARAJ",
        "first_name": "PRATHAB",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-19",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD443519",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "46888",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "46888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.