NPIMap

Individual provider Active NPI

Leelanand Prabhu Rachakonda, M.D.

  • Diagnostic Radiology Physician
  • Eden Prairie, MN
National Provider Identifier
1104105626
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
16541 Issued in NV
Practice address
11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349
Phone
(952) 595-1301
Fax
(612) 294-4903
NPI assigned
Aug 15, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 16541 NV Primary

Addresses

Primary practice location

11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349

Mailing address

2801 Alta Dr
Las Vegas, NV 89107-3201
Phone (650) 740-0431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CO, WV, PA4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20160804000522 NV Practitioner - Diagnostic Radiology 8527200658 Reassigns benefits to 4 organizations
I20241209000117 CO Practitioner - Diagnostic Radiology 8527200658 Reassigns benefits to 1 organization
I20260513000474 WV Practitioner - Diagnostic Radiology 8527200658 Reassigns benefits to 1 organization
I20260602001338 PA Practitioner - Diagnostic Radiology 8527200658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Shelin Agrawal and Hyer PLLCGroup PAC ID 5890955959, 65 clinicians
Yampa Valley Medical CenterGroup PAC ID 5890685689, 128 clinicians
Radiology Specialists LTD Marasso-MillerGroup PAC ID 0143110874, 136 clinicians
Ellis Bandt Birkin Kollins and Wong PLLCGroup PAC ID 4486568946, 68 clinicians

Practice addresses (Care Compare)

Las Vegas, NV 89106
Phone (702) 759-8600

1024 Central Park Dr
Steamboat SPR, CO 80487-8813
Phone (970) 879-1322

2020 Palomino LN
Las Vegas, NV 89106-4842
Phone (904) 399-5550

2020 Palomino LN
Suite 100
Las Vegas, NV 89106-4894
Phone (702) 759-8600

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (866) 722-1655

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.72 of 100Reported as apm
Quality
84.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16541NVMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yampa Valley Medical Center CurrentSince Oct 1, 2024 Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Sep 5, 2023 Accepting new patients
Radiology Specialists LTD Marasso-Miller Diagnostic Radiology CurrentSince Jan 29, 2021 Accepting new patients
Optum Medical Group Rhodes P C Current Accepting new patients
Yampa Valley Medical Center Current Accepting new patients
Synergy Radiology Associates PLLC CurrentSince May 1, 2019 Accepting new patients
Yampa Valley Medical Center CurrentSince Oct 1, 2024 Accepting new patients
Synergy Radiology Associates PastSince Jun 11, 2023 Accepting new patients

Locations

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

1024 Central Park Dr
Steamboat Springs, CO 80487
Phone (970) 824-1322

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

3100 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 225-5025

7130 Smoke Ranch Rd
Ste 101
Las Vegas, NV 89128
Phone (702) 304-8135

9300 W Sunset Rd
Las Vegas, NV 89148
Phone (702) 880-2100

2716 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 240-8934

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

Organizations & group practices 12

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 10

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": "1313366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1104105626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 ALTA DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891073201",
            "telephone_number": "650-740-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACHAKONDA",
        "first_name": "LEELANAND",
        "middle_name": "PRABHU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-15",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "16541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.