Premraj Makkuni, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

MD433572 Issued in PA

Practice address

154 Exton Square Mall
Exton, PA 19341-2440

Phone

(484) 476-1000

Fax

(484) 876-2164

NPI assigned

May 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI, PA2 enrollments

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 2

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Paoli Hospital Hospital, Paoli, PA, CCN 390153
• Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
• Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
• Riddle Memorial Hospital Hospital, Media, PA, CCN 390222

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment Care Compare group NPD
• Coatesville Cardiology Clinic LLC

  dba Brandywine Valley Cardiology

  • Cardiovascular Disease Physician
  • Thorndale, PA
  • NPI 1427369404
  Medicare reassignment NPD
• West Grove Clinic Company LLC

  dba Cardiology West Grove Tower Health Medical Group

  • Family Medicine Physician
  • West Grove, PA
  • NPI 1790856078

  Cardiovascular Disease

  Medicare reassignment NPD
• Aspirus Medford Hospital & Clinics, Inc.

  dba Aspirus Gilman Clinic

  • Rural Health Clinic/Center
  • Gilman, WI
  • NPI 1285703173
  Medicare reassignment NPD
• Aspirus Wausau Hospital, Inc.

  dba Aspirus Wausau Hospital Hospitalists

  • Clinic/Center
  • Wausau, WI
  • NPI 1922321140
  Medicare reassignment NPD
• Reedsburg Area Medical Center, Inc.

  • Critical Access Hospital
  • Reedsburg, WI
  • NPI 1891796710
  Medicare reassignment NPD
• Aspirus Medical Group, Inc.

  dba Aspirus Womens Health

  • Clinic/Center
  • Wausau, WI
  • NPI 1003021452
  Medicare reassignment
• West Grove Clinic Company LLC

  dba Telemedicine Jennersville Tower Health Medical Group

  • Neurology Physician
  • West Grove, PA
  • NPI 1093355992
  NPD
• Aspirus Medford Hospital & Clinics, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Medford, WI
  • NPI 1427105923
  NPD
• Aspirus Medford Hospital & Clinics, Inc.

  dba Aspirus Athens Clinic

  • Rural Health Clinic/Center
  • Athens, WI
  • NPI 1760912919
  NPD
• Aspirus Medical Group, Inc.

  dba Aspirus Business Health

  • Clinic/Center
  • Wausau, WI
  • NPI 1669595294
  NPD
• Aspirus Medical Group, Inc.

  dba Aspirus Podiatry Associates

  • Podiatric Clinic/Center
  • Wausau, WI
  • NPI 1689976474
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Main Line Hospitals, Inc.

  dba Paoli Hospital

  • General Acute Care Hospital
  • Paoli, PA
  • NPI 1215042114
  Care Compare affiliation
• Main Line Hospitals, Inc.

  dba Lankenau Hospital

  • General Acute Care Hospital
  • Wynnewood, PA
  • NPI 1245335629
  Care Compare affiliation
• Main Line Hospitals, Inc.

  dba Bryn Mawr Hospital

  • General Acute Care Hospital
  • Bryn Mawr, PA
  • NPI 1508971441
  Care Compare affiliation
• Riddle Memorial Hospital

  • General Acute Care Hospital
  • Media, PA
  • NPI 1407856099
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1730395740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 W CHESTER PIKE STE 160",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 EXTON SQUARE MALL",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193412440",
            "telephone_number": "484-476-1000",
            "fax_number": "484-876-2164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 E Racine St",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535462343",
            "country_code": "US",
            "telephone_number": "608-371-8000",
            "fax_number": "608-371-8942",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 E Racine St",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535462343",
            "country_code": "US",
            "telephone_number": "608-371-8000",
            "fax_number": "608-371-8942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAKKUNI",
        "first_name": "PREMRAJ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "57526-020",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD433572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH INSURANCE",
            "identifier": "61338",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Main Line Hospitals, Inc.
• Main Line Pain & Acupuncture Center, LLC.
• Main Line Rehabilitation Associates
• Main Line Rehabilitation Associates Inc
• Hardikkumar Makadia, DMD
• Marina V. Makous, MD
• Shamika Maldonado, LPN,PCHA
• Sharlene Joy Mallon, OTR/L
• Mama816 LLC (Home Helpers - Direct Link)
• Anthony Mangiaracina III, D.O.

• Cardiovascular Disease Physician in Exton, PA
• Providers in Exton, PA by specialty
• Cardiovascular Disease Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.