NPIMap

Individual provider Active NPI

Pradeep K Pradhan, MD

  • Internal Medicine Physician
  • Danville, VA
National Provider Identifier
1568465854
Registry record updated Apr 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101053120 Issued in VA
Practice address
414 Park Ave
Ste F
Danville, VA 24541-4630
Phone
(434) 857-3600
Fax
(434) 200-1654
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101053120 VA Primary

Addresses

Primary practice location

414 Park Ave
Ste F
Danville, VA 24541-4630

Mailing address

414 Park Ave
Ste F
Danville, VA 24541-4630
Phone (434) 857-3600

Other identifiers 2

IdentifierTypeStateIssuer
280236OtherVAANTHEM
5811104MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20070525000362 VA Practitioner - Internal Medicine 3173587359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians
Professional Therapies of Roanoke, Inc.Group PAC ID 3375710619, shared by 5 NPIs, 272 clinicians

Practice addresses (Care Compare)

110 Exchange St
Suite F
Danville, VA 24541-3500
Phone (434) 791-1562

165 Holt Garrison Pkwy
Danville, VA 24540-5949
Phone (434) 688-0163

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.16 of 100Reported as apm
Quality
83.58
Promoting interoperability
94
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101053120VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC CurrentSince Oct 1, 2010 Accepting new patients
Danville Physician Practices LLC Past Accepting new patients

Locations

110 Exchange St
Ste F
Danville, VA 24541
Phone (434) 791-1562

414 Park Ave
Ste F
Danville, VA 24541
Phone (434) 857-3600

414 Park Ave
Danville, VA 24541
Phone (434) 791-4892

140 Vista Centre Dr
Fl 2
Forest, VA 24551
Phone (434) 200-2297

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19847/brand/3/csg/21/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
VA Baptist Lynchburg General HospitalDanville, VA, CCN 498954 Rural health clinic W-2 Managing Employee Nov 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493337600000",
    "number": "1568465854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 PARK AVE",
            "address_2": "STE F",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245414630",
            "telephone_number": "434-857-3600",
            "fax_number": "434-200-1654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 PARK AVE",
            "address_2": "STE F",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245414630",
            "telephone_number": "434-857-3600",
            "fax_number": "434-200-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRADHAN",
        "first_name": "PRADEEP",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2017-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101053120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "280236",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5811104",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

Verify at the official NPI Registry.