Individual provider Active NPI

Prakashchandra M Rao, MD

  • Specialist
  • Bronx, NY
National Provider Identifier
1376647511
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
129784 Issued in NY
Practice address
3130 Grand Concourse
Suite 1K
Bronx, NY 10458-1213
Phone
(718) 365-7255
Fax
(718) 365-7558
NPI assigned
Sep 8, 2006
Last updated
Apr 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 129784 NY Primary

Addresses

Primary practice location

3130 Grand Concourse
Suite 1K
Bronx, NY 10458-1213

Mailing address

3130 Grand Concourse
Suite 1K
Bronx, NY 10458-1213
Phone (718) 365-7255

Other identifiers 1

IdentifierTypeStateIssuer
00764383MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

NPI Registry JSON

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1376647511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 GRAND CONCOURSE",
            "address_2": "SUITE 1K",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104581213",
            "telephone_number": "718-365-7255",
            "fax_number": "718-365-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 GRAND CONCOURSE",
            "address_2": "SUITE 1K",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104581213",
            "telephone_number": "718-365-7255",
            "fax_number": "718-365-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAO",
        "first_name": "PRAKASHCHANDRA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-08",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "129784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00764383",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.