Individual provider Active NPI

Ramya Prabhu

  • Anatomic Pathology Physician
  • Boston, MA
National Provider Identifier
1295311033
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
036.180028 Issued in IL
Practice address
75 Francis St
Boston, MA 02115-6106
Phone
(617) 732-8613
NPI assigned
Mar 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 036.180028 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6106

Mailing address

3503 12TH Street CT
Moline, IL 61265-7158
Phone (309) 736-6292

Other practice location 1

1775 Dempster St
Park Ridge, IL 60068-1143
Phone (847) 723-6268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20260604004110 IL Practitioner - Pathology 9739589839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1919 S Highland Ave
Building a Suite 210
Lombard, IL 60148-6153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036.180028ILMDAnatomic Pathology Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1295311033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3503 12TH STREET CT",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612657158",
            "telephone_number": "309-736-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156106",
            "telephone_number": "617-732-8613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1775 Dempster St",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681143",
            "country_code": "US",
            "telephone_number": "847-723-6268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRABHU",
        "first_name": "RAMYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "IL",
            "license": "036.180028",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.