Pradeep R. Bankulla, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD431933 Issued in PA

Practice address

4900 Frankford Ave
Attn: Radiology
Philadelphia, PA 19124-2618

Phone

(602) 910-6887

Fax

(215) 612-5077

NPI assigned

Jun 10, 2006

Sex

Male

Sole proprietor

No

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.

• Progressive Physician Assoc Inc

  • Diagnostic Radiology Physician
  • Bethlehem, PA
  • NPI 1881646859
  Medicare reassignment Care Compare group NPD Diagnostic Radiology, NJ, PA
• Jefferson University Physicians

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1326093675
  Medicare reassignment NPD Diagnostic Radiology, PA
• Pottstown Clinic Company LLC

  • Family Medicine Physician
  • Pottstown, PA
  • NPI 1649341934
  Medicare reassignment NPD Diagnostic Radiology, PA
• Radiology Consulting of Long Island PLLC

  • Diagnostic Radiology Physician
  • West Islip, NY
  • NPI 1568402410
  NPD (past) Diagnostic Radiology

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

• GSL Hospital

  • General Acute Care Hospital
  • Orwigsburg, PA
  • NPI 1265096069
  Care Compare affiliation Hospital
• St Luke'S Hospital

  • General Acute Care Hospital
  • Allentown, PA
  • NPI 1366011413
  Care Compare affiliation Hospital
• St Luke'S Hospital

  • General Acute Care Hospital
  • Easton, PA
  • NPI 1376339226
  Care Compare affiliation Hospital
• St Luke'S Hospital

  • General Acute Care Hospital
  • Lehighton, PA
  • NPI 1528737988
  Care Compare affiliation Hospital
• St Lukes Hospital

  • General Acute Care Hospital
  • Bethlehem, PA
  • NPI 1013933175
  Care Compare affiliation Hospital
• St Lukes Quakertown Hospital

  • General Acute Care Hospital
  • Quakertown, PA
  • NPI 1669405072
  Care Compare affiliation Hospital
• St. Luke'S Hospital

  • General Acute Care Hospital
  • Allentown, PA
  • NPI 1548293954
  Care Compare affiliation Hospital
• St. Luke'S Hospital Bethlehem

  • Adult Mental Health Clinic/Center
  • Lehighton, PA
  • NPI 1962094920
  Care Compare affiliation Hospital
• St. Luke'S Hospital Grand View Campus

  • General Acute Care Hospital
  • Sellersville, PA
  • NPI 1568459287
  Care Compare affiliation Hospital
• St. Luke'S Warren Hospital, Inc.

  • General Acute Care Hospital
  • Phillipsburg, NJ
  • NPI 1760488266
  Care Compare affiliation Hospital

Specialty

Diagnostic RadiologyAlso: Interventional Radiology

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Progressive Physician Assoc Inc 164 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049
• St Luke'S Hospital - Upper Bucks Campus Hospital, Quakertown, PA, CCN 390035
• St Luke'S Hospital - Grand View Campus Hospital, Sellersville, PA, CCN 390057
• Geisinger St. Luke'S Hospital Hospital, Orwigsburg, PA, CCN 390332
• St Luke'S Warren Hospital Hospital, Phillipsburg, NJ, CCN 310060

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 26, 2019.

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1235171968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 782743",
            "address_2": "ATTN: CREDENTIALING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191782743",
            "telephone_number": "602-910-6887",
            "fax_number": "215-612-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 FRANKFORD AVE",
            "address_2": "ATTN: RADIOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191242618",
            "telephone_number": "602-910-6887",
            "fax_number": "215-612-5077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10800 Knights Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191144200",
            "country_code": "US",
            "telephone_number": "215-612-4811",
            "fax_number": "215-612-5494",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2451 Grant Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191141031",
            "country_code": "US",
            "telephone_number": "215-464-8050",
            "fax_number": "215-673-6576",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10160 Bustleton Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191163749",
            "country_code": "US",
            "telephone_number": "215-827-8200",
            "fax_number": "215-969-7374",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "380 Oxford Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Langhorne",
            "state": "PA",
            "postal_code": "190478304",
            "country_code": "US",
            "telephone_number": "215-949-5111",
            "fax_number": "215-949-7815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANKULLA",
        "first_name": "PRADEEP",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "MD431933",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD431933",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NJ",
            "license": "25MA08298700",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA08298700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Banks
• Khadijah Banks
• Reginald Banks, PH.D.
• Tameeka Banks
• Trinady Banks, M.ED, LBS
• Theresa Banmeke, CRNP
• Amr Bannan, MD
• Banner Care LLC
• David W Banner, MD
• Marc P Banner, MD

• All providers in Philadelphia, PA
• Diagnostic Radiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.