Individual provider Active NPI

Kalpana R Prasad, MD

  • Psychiatry Physician
  • Gainesville, GA
National Provider Identifier
1346371622
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
74760 Issued in GA
Practice address
200 Wisteria Dr
Gainesville, GA 30501-3827
Phone
(770) 219-5407
NPI assigned
Mar 8, 2007
Last updated
Feb 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD072673L PA
Psychiatry Physician 2084P0800X 74760 GA Primary

Addresses

Primary practice location

200 Wisteria Dr
Gainesville, GA 30501-3827

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

130 S Bryn Mawr Ave
Psychiatric Unit
Bryn Mawr, PA 19010-3121
Phone (484) 337-4286

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kprasad107075@nghs.gadirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20200821002793 GA Practitioner - Psychiatry 3274445838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74760GAMDPsychiatry Physician
MD072673LPAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc CurrentSince Aug 14, 2020 Accepting new patients
Path (People Acting to Help), Inc Past Accepting new patients
Health Access Network Past Accepting new patients
Growth Opportunity Center Past Accepting new patients
Horizon House - Delaware Inc Past Accepting new patients

Locations

200 Wisteria Dr
Gainesville, GA 30501
Phone (770) 219-3800

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

Interoperability endpoints

  • Direct secure messaging: kprasad107075@nghs.gadirect.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1346371622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WISTERIA DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013827",
            "telephone_number": "770-219-5407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 S Bryn Mawr Ave",
            "address_2": "Psychiatric Unit",
            "address_purpose": "LOCATION",
            "city": "Bryn Mawr",
            "state": "PA",
            "postal_code": "190103121",
            "country_code": "US",
            "telephone_number": "484-337-4286",
            "fax_number": "484-337-4293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRASAD",
        "first_name": "KALPANA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD072673L",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "74760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kprasad107075@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "200 Wisteria Dr",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.