Prashanta Bharadwaja Kolluru, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101255970 Issued in VA

Practice address

1602 Skipwith Rd
Richmond, VA 23229-5298

Phone

(804) 289-4500

NPI assigned

Oct 15, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Internal Medicine

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Intensivist Services PCGroup PAC ID 9335152107, 234 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henrico Doctors' Hospital Hospital, Richmond, VA, CCN 490118

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Southeastern Intensivist Services PC

  • Hospitalist Physician
  • West Memphis, AR
  • NPI 1912942665

  Internal Medicine, VA

  Medicare reassignment Care Compare group NPD

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

• HCA Health Services of Virginia Inc

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1194762294
  Care Compare affiliation

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

{
    "created_epoch": "1318636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1629353115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 SKIPWITH RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232295298",
            "telephone_number": "804-289-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 SKIPWITH RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232295298",
            "telephone_number": "804-289-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLURU",
        "first_name": "PRASHANTA",
        "middle_name": "BHARADWAJA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-15",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101255970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Wayne Kolb, D.O.
• Megan Elizabeth Kolbe
• Bharadhwaj Kolipakkam, MD
• Miriam Koller Pizzani, MD
• Roger Alan Koller
• Haley Kolos
• Ellen Koltz, LCSW
• Kathleen Ryer Komornik, OD
• Daniel J Komorowski, M.D.
• John A. Komtopanos Jr., DDS

• Internal Medicine Physician in Richmond, VA
• Providers in Richmond, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.