NPIMap

Individual provider Active NPI

Prasad Balkrishna Bichu, MD

  • Nephrology Physician
  • Beaver, PA
National Provider Identifier
1679675748
Registry record updated Aug 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD454185 Issued in PA
Practice address
1000 Dutch Ridge Rd
Beaver, PA 15009-9727
Phone
(724) 773-1941
Fax
(724) 773-8370
NPI assigned
Sep 1, 2006
Last updated
Aug 5, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X 2010015537 MO
Nephrology Physician 207RN0300X MD454185 PA Primary
Nephrology Physician 207RN0300X 2010015537 MO

Addresses

Primary practice location

1000 Dutch Ridge Rd
Beaver, PA 15009-9727

Mailing address

1000 Dutch Ridge Rd
Beaver, PA 15009-9727
Phone (724) 773-1941

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
I20170330000393 VA Practitioner - NephrologyPractitioner - Internal Medicine 5698922805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nephrology Associates of Tidewater LTDGroup PAC ID 3173426558, 24 clinicians

Practice addresses (Care Compare)

2476 Nimmo Pkwy
Suite 109
Virginia Beach, VA 23456-2594
Phone (757) 689-0211

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD454185PAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Tidewater LTD Nephrology CurrentSince Feb 1, 2017 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

301 Riverview Ave
Ste 600
Norfolk, VA 23510
Phone (757) 627-7301

6160 Kempsville Cir
Ste 302A
Norfolk, VA 23502
Phone (757) 466-9288

3640 High St
Ste 2G
Portsmouth, VA 23707
Phone (757) 483-6100

1800 Camelot Dr
Ste 401
Virginia Beach, VA 23454
Phone (757) 496-3706

2476 Nimmo Pkwy
Ste 109
Virginia Beach, VA 23456
Phone (757) 689-0211

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/0000397
  • Direct secure messaging: prasadbichu@natltd.allscriptsdirect.net

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

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470355200000",
    "number": "1679675748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 DUTCH RIDGE RD",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150099727",
            "telephone_number": "724-773-1941",
            "fax_number": "724-773-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 DUTCH RIDGE RD",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150099727",
            "telephone_number": "724-773-1941",
            "fax_number": "724-773-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BICHU",
        "first_name": "PRASAD",
        "middle_name": "BALKRISHNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2016-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "MO",
            "license": "2010015537",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD454185",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MO",
            "license": "2010015537",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver, PA

Sources for this page

Verify at the official NPI Registry.