Individual provider Active NPI

Joseph Prah, MD

  • Medical Oncology Physician
  • Wooster, OH
National Provider Identifier
1689787731
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
35130168 Issued in OH
Practice address
1761 Beall Ave Ste 1
Wooster, OH 44691-2342
Phone
(330) 262-2800
Fax
(330) 262-2807
NPI assigned
Aug 15, 2006
Last updated
Nov 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 4301108930 MI
Medical Oncology Physician 207RX0202X 205729 NY
Medical Oncology Physician 207RX0202X 35130168 OH Primary

Addresses

Primary practice location

1761 Beall Ave Ste 1
Wooster, OH 44691-2342

Mailing address

1761 Beall Ave Ste 1
Wooster, OH 44691-2342
Phone (330) 262-2800

Other identifiers 3

IdentifierTypeStateIssuer
0199484MedicaidOH
01863469MedicaidNY
H310670OtherOHMEDICARE PIN

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
I20170202002452 OH Practitioner - Medical Oncology 7911071956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bloomington Medical Services LLCGroup PAC ID 9032297627, 106 clinicians

Practice addresses (Care Compare)

2326 A Eagle Pass
Wooster, OH 44691-5338
Phone (330) 202-3477

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
205729NYMDMedical Oncology Physician
35130168OHMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bloomington Medical Services LLC CurrentSince Jan 4, 2017 Accepting new patients
Lawrence M. Stallings, MD, LTD PastSince Jan 4, 2017 Accepting new patients

Locations

1761 Beall Ave
Wooster, OH 44691
Phone (330) 263-8100

1761 Beall Ave
Ste 1
Wooster, OH 44691
Phone (303) 262-2800

2326A Eagle Pass
Wooster, OH 44691
Phone (330) 202-3477

Interoperability endpoints

  • Direct secure messaging: jprah68791@direct.bronsonhg.org

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 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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1689787731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1761 BEALL AVE STE 1",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912342",
            "telephone_number": "330-262-2800",
            "fax_number": "330-262-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 BEALL AVE STE 1",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912342",
            "telephone_number": "330-262-2800",
            "fax_number": "330-262-2807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAH",
        "first_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MI",
            "license": "4301108930",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NY",
            "license": "205729",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "OH",
            "license": "35130168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0199484",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01863469",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "H310670",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.