Individual provider Active NPI

Prasanna K Muniyappa, MD

  • Internal Medicine Physician
  • Marysville, OH
National Provider Identifier
1689667594
Registry record updated Jan 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-073558 Issued in OH
Practice address
660 London Ave
Suite a
Marysville, OH 43040-1515
Phone
(937) 642-1550
Fax
(937) 578-2821
NPI assigned
Aug 25, 2005
Last updated
Jan 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35-073558 OH Primary

Addresses

Primary practice location

660 London Ave
Suite a
Marysville, OH 43040-1515

Mailing address

660 London Ave
Suite a
Marysville, OH 43040-1515
Phone (937) 642-1550

Other identifiers 1

IdentifierTypeStateIssuer
2185371MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040615000406 OH Practitioner - Internal Medicine 4688658032 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Northeastern Ohio University College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

388 Damascus Rd
Marysville, OH 43040-5535
Phone (937) 578-2626

660 London Ave
Marysville, OH 43040-1515
Phone (937) 642-1550

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-073558OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital of Union County CurrentSince Jun 29, 2009 Accepting new patients
Union County Physician Corporation CurrentSince May 1, 2017 Accepting new patients
Memorial Hospital of Union County Internal Medicine CurrentSince Jun 29, 2009 Accepting new patients
Union County Physician Corporation CurrentSince May 1, 2017 Accepting new patients
Internal Medicine Physicians of Central Ohio LLC Internal Medicine Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

120 Colemans Crossing Blvd
Marysville, OH 43040
Phone (937) 578-4200

120 Colemans Crossing Blvd
Ste C
Marysville, OH 43040
Phone (937) 578-4200

388 Damascus Rd
Marysville, OH 43040
Phone (937) 578-2626

500 London Ave
Marysville, OH 43040
Phone (740) 420-8451

660 London Ave
Marysville, OH 43040
Phone (614) 293-4967

660 London Ave
Ste A
Marysville, OH 43040
Phone (937) 578-4206

Interoperability endpoints

  • Direct secure messaging: pmuniyappa889262@direct.osumc.edu

Organizations & group practices 6

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 3

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": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515974400000",
    "number": "1689667594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 LONDON AVE",
            "address_2": "SUITE A",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430401515",
            "telephone_number": "937-642-1550",
            "fax_number": "937-578-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 LONDON AVE",
            "address_2": "SUITE A",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430401515",
            "telephone_number": "937-642-1550",
            "fax_number": "937-578-2821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNIYAPPA",
        "first_name": "PRASANNA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2018-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-073558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2185371",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, OH

Sources for this page

Verify at the official NPI Registry.