Individual provider Active NPI

Prabhakaran K Nambiar, MD

  • Spinal Cord Injury Medicine Physician
  • Prescott Valley, AZ
National Provider Identifier
1386662203
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Spinal Cord Injury Medicine PhysicianTaxonomy code 2081P0004X
License
0101038579 Issued in VA
Practice address
3700 N Windsong Dr
Prescott Valley, AZ 86314-1253
Phone
(928) 759-8800
Fax
(804) 861-0050
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Spinal Cord Injury Medicine Physician 2081P0004X 0101038579 VA Primary

Addresses

Primary practice location

3700 N Windsong Dr
Prescott Valley, AZ 86314-1253

Mailing address

3700 N Windsong Dr
Prescott Valley, AZ 86314-1253
Phone (928) 759-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160227000074 VA Practitioner - Physical Medicine and Rehabilitation 6406085612 Practice locations: Petersburg, VA
I20180223001937 AZ Practitioner - Physical Medicine and RehabilitationPractitioner - Other (Physician) 6406085612 Practice locations: Prescott Valley, AZ

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
53.57 of 100Reported as individual
Quality
71.35
Improvement activities
0
Cost
72.71

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vibra Physicians LLC CurrentSince Apr 6, 2019 Accepting new patients
Mountain Valley Regional Rehabilitation Hospital Inc Past Accepting new patients

Locations

3700 N Windsong Dr
Prescott Vly, AZ 86314
Phone (575) 640-3382

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1386662203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 N WINDSONG DR",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141253",
            "telephone_number": "928-759-8800",
            "fax_number": "928-443-8941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 N WINDSONG DR",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141253",
            "telephone_number": "928-759-8800",
            "fax_number": "804-861-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMBIAR",
        "first_name": "PRABHAKARAN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P0004X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
            "state": "VA",
            "license": "0101038579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

Verify at the official NPI Registry.