Suresh G Prabhu MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

9867 Issued in NV

Legal business name

SURESH G PRABHU MD PC

Practice address

653 N Town Center Dr
217
Las Vegas, NV 89144-0514

Phone

(702) 256-3637

Fax

(702) 256-8510

NPI assigned

Jul 25, 2006

Organization subpart

No

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

Authorized official

Name

Suresh Gopalakrishna Prabhu, MDNPI 1730111436

Title

Owner

Phone

(702) 256-3637

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Suresh Gopalakrishna Prabhu, MD

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1730111436
  Medicare reassignment Care Compare group NPD Authorized official
• Stacey Louise Siese, NP

  • Nurse Practitioner
  • Las Vegas, NV
  • NPI 1669092367
  Medicare reassignment Care Compare group NPD
• Mark Joel Rivera Culanag, NP-C

  • Family Nurse Practitioner
  • Las Vegas, NV
  • NPI 1306489331
  Medicare reassignment NPD
• Arianne Carisse Reyes Pineda, APRN-CNP

  • Family Nurse Practitioner
  • Las Vegas, NV
  • NPI 1821852054
  Medicare reassignment NPD
• Todd G. Gottschalk, DO

  • Internal Medicine Physician
  • Spokane, WA
  • NPI 1457456873
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1295757250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 N TOWN CENTER DR",
            "address_2": "217",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891440514",
            "telephone_number": "702-256-3637",
            "fax_number": "702-256-8510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 N TOWN CENTER DR",
            "address_2": "217",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891440514",
            "telephone_number": "702-256-3637",
            "fax_number": "702-256-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURESH G PRABHU MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "PRABHU",
        "authorized_official_first_name": "SURESH",
        "authorized_official_middle_name": "GOPALAKRISHNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-256-3637",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "9867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Supportive Outreach Services Inc.
• Supreme Behavioral Health Services L.L.C.
• Supreme Dental
• Surbhi Surana
• Teja Venkatahara Surapaneni, M.D.
• Suresh K Makhija MD Prof Corp
• Surgeons Surgery Center Sorelle PLLC
• Surgery Center LLC
• Surgiblue LLC
• Surgical Advisors Inc

• Internal Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.