NPIMap

Individual provider Active NPI

Vivek Subramanian Prakash, MD

  • Vascular Surgery Physician
  • Boston, MA
National Provider Identifier
1477946036
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
1028471 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2696
Phone
(617) 726-2000
NPI assigned
Mar 6, 2015
Last updated
Oct 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Vascular Surgery Physician 2086S0129X 39970 NH
Vascular Surgery Physician 2086S0129X 1028471 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2696

Mailing address

4315 Diplomacy Dr
Anchorage, AK 99508-5926

Other practice location 1

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 563-2662

Other practice location 2

10 Members Way Ste 301
Dover, NH 03820-5933
Phone (603) 609-6685

Other identifiers 1

IdentifierTypeStateIssuer
3156655MedicaidNH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220919002414 TX Practitioner - Vascular Surgery 5991180523 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 563-2662

5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone (214) 590-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)12
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Oct 1, 2022 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Oct 1, 2022 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Nov 3, 2025 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

12400 Dallas Pkwy
Frisco, TX 75033
Phone (469) 495-2000

3621 22nd St
Ste 400
Lubbock, TX 79410
Phone (806) 791-8484

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 4

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 57

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1425600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791244800000",
    "number": "1477946036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 DIPLOMACY DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-726-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4315 Diplomacy Dr",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995085926",
            "country_code": "US",
            "telephone_number": "907-563-2662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Members Way Ste 301",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "NH",
            "postal_code": "038205933",
            "country_code": "US",
            "telephone_number": "603-609-6685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRAKASH",
        "first_name": "VIVEK",
        "middle_name": "SUBRAMANIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-06",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NH",
            "license": "39970",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MA",
            "license": "1028471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3156655",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.