NPIMap

Individual provider Active NPI

Suresh Gopalakrishna Prabhu, MD

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1730111436
Registry record updated Sep 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9867 Issued in NV
Practice address
7100 Smoke Ranch Rd
Las Vegas, NV 89128-8383
Phone
(702) 545-0751
Fax
(702) 818-4817
NPI assigned
Jul 6, 2006
Last updated
Sep 4, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2023

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 9867 NV Primary

Addresses

Primary practice location

7100 Smoke Ranch Rd
Las Vegas, NV 89128-8383

Mailing address

7100 Smoke Ranch Rd
Las Vegas, NV 89128-8383
Phone (702) 545-0751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20041014000962 NV Practitioner - Internal Medicine 3779543657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suresh G Prabhu MD PCGroup PAC ID 1153328877, 2 clinicians

Practice addresses (Care Compare)

7100 Smoke Ranch Rd
Suite 100
Las Vegas, NV 89128-8834
Phone (702) 545-0751

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
23.99 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
79.96

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Suresh G Prabhu MD PC Internal Medicine CurrentSince Aug 1, 2006 Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients

Locations

653 N Town Center Dr
Ste 217
Las Vegas, NV 89144
Phone (702) 462-2659

7100 Smoke Ranch Rd
Ste 100
Las Vegas, NV 89128
Phone (702) 545-0751

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 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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1730111436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 SMOKE RANCH RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891288383",
            "telephone_number": "702-545-0751",
            "fax_number": "702-818-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 SMOKE RANCH RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891288383",
            "telephone_number": "702-545-0751",
            "fax_number": "702-818-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRABHU",
        "first_name": "SURESH",
        "middle_name": "GOPALAKRISHNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "9867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.