NPIMap

Individual provider Active NPI

Prakash Sampath, MD

  • Neurological Surgery Physician
  • Providence, RI
National Provider Identifier
1689657306
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
MD10126 Issued in RI
Practice address
120 Dudley St
Providence, RI 02905-2436
Phone
(401) 273-4155
Fax
(401) 273-4115
NPI assigned
Nov 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 205361 MA
Neurological Surgery Physician 207T00000X MD10126 RI Primary

Addresses

Primary practice location

120 Dudley St
Providence, RI 02905-2436

Mailing address

118 Dudley St
Providence, RI 02905-2403
Phone (401) 273-4155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20040122000974 RI Practitioner - Neurosurgery 9335041177 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Columbia University College of Physicians and Surgeons, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-4000

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Warwick, RI, CCN 417036
  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007
  • Roger Williams Medical Center Hospital, Providence, RI, CCN 410004
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion161
Laminectomy or laminotomy (partial removal of spine bones)39

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Chartercare RWMC, LLC Current Accepting new patients
Rhode Island Hospital CurrentSince Jan 21, 2024 Accepting new patients
Rhode Island Hospital CurrentSince Jan 21, 2024 Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients
Rhode Island Hospital Past Accepting new patients
Neurosurgery Foundation, Inc. Neurological Surgery Past Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

6 Blackstone Valley Pl
Ste 706
Lincoln, RI 02865

2 Dudley St
Ste 555
Providence, RI 02905
Phone (401) 444-4169

825 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2000

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

593 Eddy St
Providence, RI 02903

593 Eddy St
#7
Providence, RI 02903
Phone (401) 444-3565

Interoperability endpoints

  • Direct secure messaging: psampath@direct.chartercare.org

Organizations & group practices 7

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 7

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1689657306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 DUDLEY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029052403",
            "telephone_number": "401-273-4155",
            "fax_number": "401-273-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 DUDLEY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029052436",
            "telephone_number": "401-273-4155",
            "fax_number": "401-273-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPATH",
        "first_name": "PRAKASH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MA",
            "license": "205361",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "RI",
            "license": "MD10126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.