Individual provider Active NPI

Nitya Prabhakaran, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Columbia, MO
National Provider Identifier
1679924120
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
2016014736 Issued in MO
Practice address
1 Hospital Dr
Department of Pathology
Columbia, MO 65212-1000
Phone
(573) 882-3014
NPI assigned
Jun 27, 2016
Last updated
Jun 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 2016014736 MO Primary

Addresses

Primary practice location

1 Hospital Dr
Department of Pathology
Columbia, MO 65212-1000

Mailing address

1 Hospital Dr
Department of Pathology
Columbia, MO 65212-1000
Phone (573) 882-3014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20220705001279 NE Practitioner - Pathology 1254711567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

601 W Leota St
Great Plains Health
North Platte, NE 69101-6525
Phone (308) 568-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016014736MOMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Platte Nebraska Hospital Corporation CurrentSince Jul 1, 2022 Accepting new patients
North Platte Nebraska Hospital Corporation Current Accepting new patients

Locations

601 W Leota St
North Platte, NE 69101
Phone (308) 534-2288

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 6

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": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1679924120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652121000",
            "telephone_number": "573-882-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652121000",
            "telephone_number": "573-882-3014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRABHAKARAN",
        "first_name": "NITYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "2016014736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.