NPIMap

Individual provider Active NPI

Channa B Prasad, M.D.

  • Cardiovascular Disease Physician
  • Bullhead City, AZ
National Provider Identifier
1477519445
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
14827 Issued in AZ
Practice address
1648 Highway 95
Bullhead City, AZ 86442-7906
Phone
(928) 758-4114
Fax
(928) 758-4650
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 14827 AZ
Cardiovascular Disease Physician 207RC0000X 14827 AZ Primary

Addresses

Primary practice location

1648 Highway 95
Bullhead City, AZ 86442-7906

Mailing address

1648 Highway 95
Bullhead City, AZ 86442-7906
Phone (928) 758-4114

Other identifiers 1

IdentifierTypeStateIssuer
249525MedicaidAZ

Other names 1

  • Channabasavanna Basava Prasad Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, AZ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070915000287 NV Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0749374122 Reassigns benefits to 1 organization
I20101028000817 AZ Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0749374122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Cardiovascular Associates Ahmed Alfafara and Prasad LTDGroup PAC ID 7810209525, 5 clinicians

Practice addresses (Care Compare)

1648 Hwy 95
Bullhead City, AZ 86442-7906
Phone (928) 758-4114

Hospital & facility affiliations

  • Valley View Medical Center Hospital, Fort Mohave, AZ, CCN 030117
  • Western Arizona Regional Medical Center Hospital, Bullhead City, AZ, CCN 030101
  • Colorado River Medical Center Hospital, Needles, CA, CCN 051323
  • Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055

Merit-based Incentive Payment System (MIPS)

Final score
96.48 of 100Reported as group
Quality
92.96
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4662NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Molecular Pet Imaging LLC CurrentSince Apr 15, 2024 Accepting new patients
North Vista Hospital LLC Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Bullhead City Hospital Corporation Past Accepting new patients

Locations

1648 Highway 95
Bullhead City, AZ 86442
Phone (928) 758-4114

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1477519445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 HIGHWAY 95",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427906",
            "telephone_number": "928-758-4114",
            "fax_number": "928-758-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1648 HIGHWAY 95",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427906",
            "telephone_number": "928-758-4114",
            "fax_number": "928-758-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRASAD",
        "first_name": "CHANNA",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "14827",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AZ",
            "license": "14827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "249525",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHANNABASAVANNA",
            "last_name": "PRASAD",
            "middle_name": "BASAVA",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bullhead City, AZ

Sources for this page

Verify at the official NPI Registry.