Individual provider Active NPI

Prakash S Gudsoorkar, MD

  • Nephrology Physician
  • Cincinnati, OH
National Provider Identifier
1417458175
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
35.138518 Issued in OH
Practice address
234 Goodman St
Cincinnati, OH 45219-2364
Phone
(513) 558-5468
Fax
(513) 558-4309
NPI assigned
Feb 27, 2018
Last updated
Jan 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 35.138518 OH Primary

Addresses

Primary practice location

234 Goodman St
Cincinnati, OH 45219-2364

Mailing address

2830 Victory Pkwy
Cincinnati, OH 45206-1785
Phone (513) 245-3072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20200306001830 OH Practitioner - Nephrology 2365870284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3188 Bellevue Ave
Cincinnati, OH 45219-2369
Phone (513) 584-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
65.97
Promoting interoperability
100
Improvement activities
40
Cost
74.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.138518OHMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Physicians Company, LLC Nephrology CurrentSince Feb 1, 2020 Accepting new patients
University of Cincinnati Medical Center, LLC Past Accepting new patients

Locations

151 W Galbraith Rd
Cincinnati, OH 45216
Phone (513) 418-2500

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

231 Albert Sabin Way
Cincinnati, OH 45267
Phone (513) 558-6356

2830 Victory Pkwy
Cincinnati, OH 45206
Phone (513) 245-3335

2830 Victory Pkwy
#806
Cincinnati, OH 45206
Phone (513) 245-3694

3130 Highland Ave
Fl 2
Cincinnati, OH 45219
Phone (513) 584-4061

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

3199 Highland Ave
Cincinnati, OH 45219
Phone (513) 475-7777

9275 Montgomery Rd
Montgomery, OH 45242
Phone (513) 936-4518

7700 University Dr
West Chester, OH 45069
Phone (513) 298-3000

Interoperability endpoints

  • Direct secure messaging: pgudsoorkar220856@direct.uchealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1417458175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 VICTORY PKWY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452061785",
            "telephone_number": "513-245-3072",
            "fax_number": "513-585-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 GOODMAN ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192364",
            "telephone_number": "513-558-5468",
            "fax_number": "513-558-4309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDSOORKAR",
        "first_name": "PRAKASH",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35.138518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.