Individual provider Active NPI

Vajravel M. Prasad, MD

  • Gastroenterology Physician
  • Newburgh, IN
National Provider Identifier
1306876560
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
01061439A Issued in IN
Practice address
3800 Venetian Way
Ste 200
Newburgh, IN 47630-8257
Phone
(812) 477-6103
Fax
(812) 477-4897
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 01061439A IN Primary

Addresses

Primary practice location

3800 Venetian Way
Ste 200
Newburgh, IN 47630-8257

Mailing address

3800 Venetian Way
Newburgh, IN 47630-8257
Phone (812) 477-6103

Other identifiers 1

IdentifierTypeStateIssuer
200395350AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20080617000608 IN Practitioner - Gastroenterology 7012018856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Care of Evansville PCGroup PAC ID 8022119858, 27 clinicians

Practice addresses (Care Compare)

3800 Venetian Way
Newburgh, IN 47630-8257
Phone (812) 477-6103

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy149
Upper gastrointestinal (GI) endoscopy for acid reflux224

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01061439AINMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Care of Evansville PC Gastroenterology CurrentSince Jan 1, 2007 Accepting new patients
Digestive Care of Evansville, PC CurrentSince Jan 1, 2007 Accepting new patients
Jasper Anesthesia Care Associates, LLC PastSince Sep 1, 2019 Accepting new patients

Locations

801 Saint Marys Dr
Ste 110W
Evansville, IN 47714
Phone (812) 469-3283

801 Saint Marys Dr
Ste 205W
Evansville, IN 47714
Phone (812) 477-6103

647 2nd St
Ste B
Jasper, IN 47546
Phone (812) 477-6103

3800 Venetian Way
Ste 200
Newburgh, IN 47630
Phone (812) 477-6103

3800 Venetian Way
Newburgh, IN 47630
Phone (812) 477-6103

Interoperability endpoints

  • Direct secure messaging: vprasad.dccmd@directaddress.net

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 3

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1306876560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 VENETIAN WAY",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308257",
            "telephone_number": "812-477-6103",
            "fax_number": "812-477-4897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 VENETIAN WAY",
            "address_2": "STE 200",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308257",
            "telephone_number": "812-477-6103",
            "fax_number": "812-477-4897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRASAD",
        "first_name": "VAJRAVEL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2021-11-10",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01061439A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200395350A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, IN

Sources for this page

Verify at the official NPI Registry.