Individual provider Active NPI

Prasad N. Policherla

  • Neurology Physician
  • Defiance, OH
National Provider Identifier
1619959665
Registry record updated Apr 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
35065457 Issued in OH
Practice address
1400 E 2ND St
Defiance, OH 43512-2440
Phone
(419) 784-1414
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 35065457 OH Primary

Addresses

Primary practice location

1400 E 2ND St
Defiance, OH 43512-2440

Mailing address

1400 E 2ND St
Defiance, OH 43512-2440
Phone (419) 784-1414

Other identifiers 2

IdentifierTypeStateIssuer
130020927OtherOHRAILROAD
2123473MedicaidOH

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
I20100202000503 OH Practitioner - Neurology 6204979016 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Medical Partners Northern Region Specialty Care LLCGroup PAC ID 9739585480, 86 clinicians

Practice addresses (Care Compare)

1400 E 2ND St
Defiance, OH 43512-2440
Phone (419) 784-1414

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Partners Northern Region LLC CurrentSince Jan 1, 2012 Accepting new patients
Mercy Medical Partners Northern Region Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Medical Partners Northern Region LLC CurrentSince Jan 1, 2012 Accepting new patients
Mercy Medical Partners Northern Region Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Fauster Cameron Inc. Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1400 E 2nd St
Defiance, OH 43512
Phone (419) 784-1414

1600 E Riverview Ave
Ste 101
Napoleon, OH 43545
Phone (419) 592-8774

2200 Jefferson Ave
Fl 5
Toledo, OH 43604
Phone (419) 251-9826

Interoperability endpoints

  • Direct secure messaging: ppolicherla59502@direct.bsmhealth.org

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 1

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271203200000",
    "number": "1619959665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E 2ND ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435122440",
            "telephone_number": "419-784-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E 2ND ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435122440",
            "telephone_number": "419-784-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLICHERLA",
        "first_name": "PRASAD",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2010-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "35065457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "130020927",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2123473",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Defiance, OH

Sources for this page

Verify at the official NPI Registry.