Individual provider Active NPI

Prasad G Kilaru

  • Plastic Surgery Physician
  • Fremont, CA
National Provider Identifier
1689674665
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A060104 Issued in CA
Practice address
39141 Civic Center Dr
Suite 110
Fremont, CA 94538-1730
Phone
(510) 791-9700
Fax
(510) 791-9703
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X A060104 CA
Plastic Surgery Physician 208200000X A060104 CA Primary

Addresses

Primary practice location

39141 Civic Center Dr
Suite 110
Fremont, CA 94538-1730

Mailing address

39141 Civic Center Dr
Suite 110
Fremont, CA 94538-1730
Phone (510) 791-9700

Other identifiers 1

IdentifierTypeStateIssuer
00A601040MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20090723000584 CA Practitioner - Plastic and Reconstructive SurgeryPractitioner - Hand Surgery 4880629187 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Township Medical FoundationGroup PAC ID 2860687050, 125 clinicians

Practice addresses (Care Compare)

39141 Civic Ctr Dr
Suite 106
Fremont, CA 94538-5878
Phone (510) 248-1520

Hospital & facility affiliations

  • Washington Hospital Hospital, Fremont, CA, CCN 050195

Merit-based Incentive Payment System (MIPS)

Final score
87.74 of 100Reported as group
Quality
66.48
Promoting interoperability
100
Improvement activities
40
Cost
75.97

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Mastectomy21
Melanoma (skin cancer) excision29
Removal of tissue57
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60104CAMDSocial Worker
A060104CAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Township Medical Foundation Family Medicine CurrentSince Sep 23, 2020 Accepting new patients
Washington Township Medical Foundation CurrentSince Sep 23, 2020 Accepting new patients
East Bay Hand & Plastic Surgery Center Inc. Plastic Surgery CurrentSince Jul 1, 2009 Accepting new patients
Deccan Pacific Medical Group, PC Past Accepting new patients
Washington Township Hospital District Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients

Locations

39141 Civic Center Dr
Ste 106
Fremont, CA 94538
Phone (510) 248-1520

39500 Fremont Blvd
Ste 100
Fremont, CA 94538
Phone (510) 248-1800

39141 Civic Center Dr
Ste 110
Fremont, CA 94538
Phone (510) 695-2500

Interoperability endpoints

  • Direct secure messaging: pkilaru13608@direct.whhs.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Amore Home HealthFremont, CA, CCN 059509 Home health agency 5% Or Greater Indirect Ownership Interest (50%)
Corporate Officer (50%)
Sep 10, 2019
Sep 10, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1689674665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39141 CIVIC CENTER DR",
            "address_2": "SUITE 110",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381730",
            "telephone_number": "510-791-9700",
            "fax_number": "510-791-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39141 CIVIC CENTER DR",
            "address_2": "SUITE 110",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381730",
            "telephone_number": "510-791-9700",
            "fax_number": "510-791-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILARU",
        "first_name": "PRASAD",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "CA",
            "license": "A060104",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A060104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A601040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.