NPIMap

Individual provider Active NPI

Praveena Vantipalli, MBBS

  • Family Medicine Physician
  • North Platte, NE
National Provider Identifier
1306405261
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34072 Issued in NE
Practice address
500 W Leota St Ste 100
North Platte, NE 69101-6578
Phone
(308) 534-4440
NPI assigned
Jun 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 8507 NE
Family Medicine Physician 207Q00000X 34072 NE Primary

Addresses

Primary practice location

500 W Leota St Ste 100
North Platte, NE 69101-6578

Mailing address

500 W Leota St Ste 100
North Platte, NE 69101-6578
Phone (308) 534-4440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220622000848 NE Practitioner - Family Practice 3173855814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Platte Nebraska Hospital CorporationGroup PAC ID 6507856697, 237 clinicians

Practice addresses (Care Compare)

601 W Leota St
North Platte, NE 69101-6525

625 W William Ave
North Platte, NE 69101-0026

Hospital & facility affiliations

  • Brookestone Home Health & Hospice Home health agency, North Platte, NE, CCN 287020
  • Great Plains Health Hospital, North Platte, NE, CCN 280065
  • The Nebraska Medical Center Hospital, Omaha, NE, CCN 280013
  • Accura HealthCare of North Platte Nursing home, North Platte, NE, CCN 285165
  • Adept Nursing & Rehab of Sutherland Nursing home, Sutherland, NE, CCN 285141
  • Adept Nursing & Rehab of North Platte Nursing home, North Platte, NE, CCN 285094
  • Linden Court Nursing home, North Platte, NE, CCN 285083

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34072NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Platte Nebraska Hospital Corporation CurrentSince Jun 13, 2022 Accepting new patients
North Platte Nebraska Hospital Corporation Current Accepting new patients
Maples at Centennial LLC Past Accepting new patients

Locations

500 W Leota St
Ste 100
North Platte, NE 69101
Phone (308) 534-4440

601 W Leota St
North Platte, NE 69101
Phone (308) 534-2288

625 W William Ave
#230
North Platte, NE 69101

625 W William Ave
Ste 230
North Platte, NE 69101
Phone (308) 534-4440

Interoperability endpoints

  • Direct secure messaging: pvantipalli249989@direct.nebraskamed.com

Organizations & group practices 3

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 8

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": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1306405261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W LEOTA ST STE 100",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016578",
            "telephone_number": "308-534-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W LEOTA ST STE 100",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016578",
            "telephone_number": "308-534-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANTIPALLI",
        "first_name": "PRAVEENA",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "8507",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "34072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Platte, NE

Sources for this page

Verify at the official NPI Registry.