Individual provider Active NPI

Sandeep Gajanan Prabhu, MD

  • Pediatric Radiology Physician
  • Oklahoma City, OK
National Provider Identifier
1689844797
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
25469 Issued in OK
Practice address
1200 Everett Dr
1Np606
Oklahoma City, OK 73104-5047
Phone
(405) 271-5125
NPI assigned
Mar 4, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X 25469 OK Primary

Addresses

Primary practice location

1200 Everett Dr
1Np606
Oklahoma City, OK 73104-5047

Mailing address

940 Stanton L Young Blvd
BMSB 357
Oklahoma City, OK 73104-5020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20110330000982 OK Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 0941483838 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ou Health Partners IncGroup PAC ID 5991105876, 1,167 clinicians

Practice addresses (Care Compare)

1200 Childrens Ave
Oklahoma City, OK 73104-4637
Phone (405) 271-2669

900 NE 10TH St
Ouhp Family Medicine
Oklahoma City, OK 73104-5420
Phone (572) 244-0065

Hospital & facility affiliations

  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093

Merit-based Incentive Payment System (MIPS)

Final score
77.26 of 100Reported as group
Quality
53.73
Promoting interoperability
100
Improvement activities
40
Cost
70.48

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jan 1, 2011 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jan 1, 2011 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
University of Oklahoma College of Medicine Past Accepting new patients
Ou Medicine Inc. Past Accepting new patients

Locations

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

940 NE 13th St
Oklahoma City, OK 73104
Phone (405) 271-2429

1200 Everett Dr
#1
Oklahoma City, OK 73104
Phone (405) 271-5068

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

940 Stanton L Young Blvd
#357
Oklahoma City, OK 73104
Phone (405) 271-2265

Interoperability endpoints

  • Direct secure messaging: sprabhu26637@ouhealth.direct-ci.net

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": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1689844797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 STANTON L YOUNG BLVD",
            "address_2": "BMSB 357",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 EVERETT DR",
            "address_2": "1NP606",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045047",
            "telephone_number": "405-271-5125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRABHU",
        "first_name": "SANDEEP",
        "middle_name": "GAJANAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "OK",
            "license": "25469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.