NPIMap

Individual provider Active NPI

Prasuna Muppa, M.B.B.S

  • Anatomic Pathology & Clinical Pathology Physician
  • Sioux Falls, SD
National Provider Identifier
1073977690
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
12661 Issued in SD
Practice address
1301 S Cliff Ave Ste 700
Sioux Falls, SD 57105-1019
Phone
(605) 322-7200
Fax
(605) 322-7222
NPI assigned
Apr 9, 2016
Last updated
Sep 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 27510 MN
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 64160 MN
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 12661 SD Primary

Addresses

Primary practice location

1301 S Cliff Ave Ste 700
Sioux Falls, SD 57105-1019

Mailing address

PO Box 5050
Sioux Falls, SD 57117-5050
Phone (605) 322-7200

Other practice location 1

200 1st St SW
Rochester, MN 55905
Phone (507) 284-2511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, IA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210603002758 SD Practitioner - Pathology 7517250780 Reassigns benefits to 1 organization
I20210730003208 IA Practitioner - Pathology 7517250780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Laboratory LTDGroup PAC ID 9234036310, 14 clinicians

Practice addresses (Care Compare)

1301 S Cliff Ave
Suite 700
Sioux Falls, SD 57105-1019
Phone (605) 322-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Laboratory of Northwest Iowa LTD Anatomic Pathology & Clinical Pathology CurrentSince Jul 21, 2021 Accepting new patients
Physicians Laboratory, LTD. Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2021 Accepting new patients
Physicians Laboratory, LTD. Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2021 Accepting new patients
Physicians Laboratory of Northwest Iowa LTD Anatomic Pathology & Clinical Pathology CurrentSince Jul 21, 2021 Accepting new patients

Locations

116 E 11th St
Ste 204
Spencer, IA 51301
Phone (712) 262-3795

1301 S Cliff Ave
Ste 700
Sioux Falls, SD 57105
Phone (605) 322-7200

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 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1460160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1073977690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5050",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175050",
            "telephone_number": "605-322-7200",
            "fax_number": "605-322-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S CLIFF AVE STE 700",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051019",
            "telephone_number": "605-322-7200",
            "fax_number": "605-322-7222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "55905",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUPPA",
        "first_name": "PRASUNA",
        "credential": "M.B.B.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-09",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "MN",
            "license": "27510",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MN",
            "license": "64160",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "SD",
            "license": "12661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.