Prabhakar Pisipati, MD

Primary specialty

Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X

License

79002 Issued in GA

Practice address

1075 Jesse Jewell Pkwy NE Ste a
Gainesville, GA 30501-3814

Phone

(770) 219-5407

NPI assigned

Jun 26, 2005

Last updated

Nov 1, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Prabhakar Pisipati Other name

Medicare fee-for-service enrollment

Enrolled in GA

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

Merit-based Incentive Payment System (MIPS)

Final score

87.83 of 100Reported as group

Quality

80.36

Promoting interoperability

100

Improvement activities

40

Cost

79.08

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northeast Georgia Physicians Group Inc

  • Family Medicine Physician
  • Gainesville, GA
  • NPI 1891745212
  Medicare reassignment NPD
• Personal Recovery Network LLC

  dba LifeStance Health

  • Psychiatry Physician
  • Stockbridge, GA
  • NPI 1881990869
  Medicare reassignment NPD
• Pisipati LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Clinton, IA
  • NPI 1326317538
  NPD (past) Authorized official
• Vera French Community Mental Health

  dba Vera French Clinic at Duck Creek

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bettendorf, IA
  • NPI 1568239978
  NPD (past)

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

{
    "created_epoch": "1119744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1649276437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 862",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527330862",
            "telephone_number": "563-219-0695",
            "fax_number": "563-519-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 JESSE JEWELL PKWY NE STE A",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013814",
            "telephone_number": "770-219-5407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1410 N 4th St",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "IA",
            "postal_code": "52132",
            "country_code": "US",
            "telephone_number": "563-244-5555",
            "fax_number": "563-884-4638",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5500 Armstrong Rd",
            "address_purpose": "LOCATION",
            "city": "Battle Creek",
            "state": "MI",
            "postal_code": "490377314",
            "country_code": "US",
            "telephone_number": "269-966-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PISIPATI",
        "first_name": "PRABHAKAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-26",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "MI",
            "license": "4301061688",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "IA",
            "license": "30143",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "GA",
            "license": "79002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA LICENSE",
            "identifier": "79002",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2115774",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRABHAKAR",
            "last_name": "PISIPATI",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Katie Smith Pinson, OT
• Arcelia Dianne De Guzman Pioquinto, DO
• Jerrid Pippin, M.D.
• Jeanette Susan Pirkle, APRN, NP-C
• Tania B. Pirkle
• Olubunmi Titilope Pitan, MD
• Platinum Dental Group Gainesville, LLC
• Platinum Dental of Gainesville (Platinum Dental Gainesville, LLC)
• Platinum EMS LLC
• Lindsay Platt, PT, DPT

• Geriatric Psychiatry Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Geriatric Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 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.