Individual provider Active NPI

Pooja Railan Prasad, D.O.

  • Pediatrics Physician
  • Fredericksburg, VA
National Provider Identifier
1396940474
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0102202348 Issued in VA
Practice address
12101 Carol LN
Fredericksburg, VA 22407
Phone
(540) 786-2100
Fax
(540) 786-0677
NPI assigned
Jun 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0102202348 VA Primary

Addresses

Primary practice location

12101 Carol LN
Fredericksburg, VA 22407

Mailing address

PO Box 1460
Fredericksburg, VA 22402-1460
Phone (540) 786-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20180123002089 VA Practitioner - Pediatric Medicine 1759461338 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Richmond Multi-Specialty, LLC CurrentSince Oct 16, 2019 Accepting new patients
Spotsylvania Multi-Specialty Group, LLC PastSince Oct 16, 2019 Accepting new patients
Lewis Plastic Surgery, PC Past Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

1451 Hospital Dr
Ste 201
Fredericksburg, VA 22401
Phone (540) 361-2040

1451 Hospital Dr
Fredericksburg, VA 22401
Phone (540) 899-5864

1451 Hospital Dr
Ste 102
Fredericksburg, VA 22401
Phone (540) 368-5350

1451 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 267-6009

Interoperability endpoints

  • Direct secure messaging: pooja.prasad@hca6.eclinicaldirectplus.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.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1396940474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1460",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224021460",
            "telephone_number": "540-786-2100",
            "fax_number": "540-786-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12101 CAROL LN",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "22407",
            "telephone_number": "540-786-2100",
            "fax_number": "540-786-0677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRASAD",
        "first_name": "POOJA",
        "middle_name": "RAILAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0102202348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.