NPIMap

Individual provider Active NPI

Prashanth Podaralla, M.D.

  • Nephrology Physician
  • Hannibal, MO
National Provider Identifier
1730226952
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
2006017617 Issued in MO
Practice address
100 Medical Dr
Hannibal, MO 63401-6877
Phone
(573) 231-3798
Fax
(573) 231-3827
NPI assigned
Jan 30, 2007
Last updated
Mar 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2006017617 MO
Nephrology Physician 207RN0300X 2006017617 MO Primary

Addresses

Primary practice location

100 Medical Dr
Hannibal, MO 63401-6877

Mailing address

100 Medical Dr
Hannibal, MO 63401-6877
Phone (573) 231-3798

Other identifiers 2

IdentifierTypeStateIssuer
1730226952MedicaidMO
137720019OtherMOMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address PPodaralla@hannibalclinic.directbygreenway.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100702000389 MO Practitioner - Nephrology 5496886699 Reassigns benefits to 1 organization
I20150820012020 IL Practitioner - Nephrology 5496886699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blessing HospitalGroup PAC ID 3072422534, 414 clinicians

Practice addresses (Care Compare)

100 Medical Dr
Hannibal, MO 63401-6877
Phone (573) 406-5800

1005 Broadway St
Quincy, IL 62301-2834

101 Medical Dr
Hannibal, MO 63401-6884
Phone (573) 221-5250

103 E Commercial St
Kahoka, MO 63445-1701
Phone (217) 223-8400

119 Progress Rd
Hannibal, MO 63401-6628
Phone (217) 223-8400

4 Town Ctr Dr
Bowling Green, MO 63334-2805
Phone (573) 221-5250

6000 Hospital Dr
Hannibal, MO 63401-6887
Phone (573) 248-1300

927 Broadway St
Quincy, IL 62301-2719
Phone (217) 224-6423

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Blessing Hospital CurrentSince Oct 1, 2021 Accepting new patients
West Central Pathology Specialists, S.C. Current Accepting new patients
Blessing Hospital CurrentSince Oct 1, 2021 Accepting new patients
Quincy Clinical Laboratory Services SC Current Accepting new patients
Blessing Hospital Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1005 Broadway St
Quincy, IL 62301

100 Medical Dr
Hannibal, MO 63401

101 Medical Dr
Hannibal, MO 63401

103 E Commercial St
Kahoka, MO 63445
Phone (660) 727-3377

1811 S Main St
Palmyra, MO 63461
Phone (573) 769-2231

Interoperability endpoints

  • FHIR API: https://fhir.blessinghospital.com/R4/open-Prod
  • Direct secure messaging: ppodaralla@hannibalclinic.directbygreenway.com

Ownership & related parties

All facility ownership & control disclosures 12

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

FacilityTypeRoleSince
Blessing HospiceQuincy, IL, CCN 141501 Hospice Corporate Director Feb 1, 2026
East Adams County Rural Health ClinicGolden, IL, CCN 143422 Rural health clinic Corporate Director Feb 1, 2026
Blessing Health - 48THQuincy, IL, CCN 148629 Rural health clinic Corporate Director Feb 1, 2026
Blessing HospitalMt Sterling, IL, CCN 148630 Rural health clinic Corporate Director Feb 1, 2026
Blessing HospitalQuincy, IL, CCN 148631 Rural health clinic Corporate Director Feb 1, 2026
Blessing Walk in ClinicQuincy, IL, CCN 148635 Rural health clinic Corporate Director Feb 1, 2026
Blessing Express ClinicQuincy, IL, CCN 148634 Rural health clinic Corporate Director Feb 1, 2026
Blessing Health HannibalHannibal, MO, CCN 268800 Rural health clinic Corporate Director Feb 1, 2026
Blessing Health PalmyraPalmyra, MO, CCN 268801 Rural health clinic Corporate Director Feb 1, 2026
Blessing Health Hamilton-WarsawWarsaw, IL, CCN 148666 Rural health clinic Corporate Director Feb 1, 2026
Blessing Employer ClinicQuincy, IL, CCN 148675 Rural health clinic Corporate Director Feb 1, 2026
Blessing Health Monroe CityMonroe City, MO, CCN 268811 Rural health clinic Corporate Director Feb 1, 2026

Owned or controlled facilities with NPI records 12

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1730226952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016877",
            "telephone_number": "573-231-3798",
            "fax_number": "573-231-3827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016877",
            "telephone_number": "573-231-3798",
            "fax_number": "573-231-3827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODARALLA",
        "first_name": "PRASHANTH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2006017617",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MO",
            "license": "2006017617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730226952",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "137720019",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PPodaralla@hannibalclinic.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 Medical Dr",
            "city": "Hannibal",
            "state": "MO",
            "country_code": "US",
            "postal_code": "634016877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.