Individual provider Active NPI

Pranitha VBR Prodduturvar, MD

  • Medical Oncology Physician
  • Mobile, AL
National Provider Identifier
1114183902
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
MD.37066 Issued in AL
Practice address
1660 Spring Hill Ave
Mobile, AL 36604-1405
Phone
(251) 665-8000
Fax
(251) 665-8010
NPI assigned
Aug 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 101698 GA
Medical Oncology Physician 207RX0202X 67420 MN
Medical Oncology Physician 207RX0202X MD.37066 AL Primary
Hospitalist Physician 208M00000X 26148 NE
Internal Medicine Physician 207R00000X 26148 NE
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 26148 NE

Addresses

Primary practice location

1660 Spring Hill Ave
Mobile, AL 36604-1405

Mailing address

PO Box 746450
Atlanta, GA 30374-6450
Phone (251) 434-3626

Other practice location 1

631 Professional Dr Ste 450
Lawrenceville, GA 30046-3370
Phone (770) 963-8030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, GA2 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
I20210823002086 AL Practitioner - Medical OncologyPractitioner - Hospice/Palliative Care 3476722992
I20250129000885 GA Practitioner - Medical Oncology 3476722992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Oncology Services LLCGroup PAC ID 1850627423, 29 clinicians

Practice addresses (Care Compare)

631 Professional Dr
Suite 450
Lawrenceville, GA 30046-3370
Phone (770) 963-8030

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
96.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26148NEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Atlanta Oncology Services LLC Medical Oncology CurrentSince Jan 20, 2025 Accepting new patients
University of South Alabama Medical Oncology Past Accepting new patients

Locations

2098 Teron Trce
Ste 400
Dacula, GA 30019
Phone (678) 312-6800

631 Professional Dr
Ste 450
Lawrenceville, GA 30046
Phone (770) 963-8030

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

Organizations & group practices 2

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 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": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1114183902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746450",
            "telephone_number": "251-434-3626",
            "fax_number": "251-445-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 SPRING HILL AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041405",
            "telephone_number": "251-665-8000",
            "fax_number": "251-665-8010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "631 Professional Dr Ste 450",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300463370",
            "country_code": "US",
            "telephone_number": "770-963-8030",
            "fax_number": "770-339-9577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRODDUTURVAR",
        "first_name": "PRANITHA",
        "middle_name": "VBR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-01",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "GA",
            "license": "101698",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MN",
            "license": "67420",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "AL",
            "license": "MD.37066",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NE",
            "license": "26148",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "26148",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NE",
            "license": "26148",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.