Prashant Raghavan, M.D.
Individual provider Active NPI Diagnostic Radiology Physician · Baltimore, MD
NPI 1740339787 · NPPES record last updated Apr 26, 2019
Key facts
- NPI
- 1740339787
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- D76040 (MD)
- Practice address
- 22 S Greene St
Department of Radiology
Baltimore, MD 21201-1544 - Phone
- (410) 328-3477
- NPI assigned
- Jan 9, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University Imaging Center, LLC
University of Maryland Diagnostic Imaging Specialists P a
University of Maryland Diagnostic Radiology, LLC
Practice addresses (Care Compare)
419 W Redwood St
Baltimore, MD 21201-1734
Phone (410) 328-3225
5 Garrett Ave
La Plata, MD 20646-5960
Phone (301) 609-4000
5 N la Plata CT
Suite 104
La Plata, MD 20646-5207
Phone (301) 539-0345
Hospital & facility affiliations
- University of Maryland Medical Center
- University of MD Capital Region Medical Center
- University of MD Medical Center Midtown Campus
- Umd Rehabilitation & Orthopaedic Institute
- University of MD Shore Medical Ctr at Chestertown
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MD, DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130913000689 | MD | Practitioner - Diagnostic Radiology | 4082637400 | Reassigns benefits to 3 organizations |
| I20181210003256 | DC | Practitioner - Diagnostic Radiology | 4082637400 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D76040 | MD | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Imaging Center, LLC | Neuroradiology | Current |
Accepting new patients |
| University of Maryland Diagnostic Radiology, LLC | Neuroradiology | Current |
Accepting new patients |
| University of Maryland Diagnostic Imaging Specialists P a | Neuroradiology | Current |
Accepting new patients |
| University of Maryland Diagnostic Radiology, LLC | Neuroradiology | Current |
Accepting new patients |
| University Imaging Center, LLC | Neuroradiology | Current |
Accepting new patients |
| University of Maryland Diagnostic Imaging Specialists P a | Neuroradiology | Current |
Accepting new patients |
| University of Virginia Physicians Group | Past |
Accepting new patients |
Locations
22 S Greene St
Rm N2E23
Baltimore, MD 21201
Phone (410) 328-5656
22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793
419 W Redwood St
Baltimore, MD 21201
Phone (410) 328-5196
5 Garrett Ave
La Plata, MD 20646
Phone (301) 609-4000
5 N La Plata Ct
Ste 104
La Plata, MD 20646
Phone (301) 539-0345
Interoperability endpoints
- praghavan85190@direct.umm.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuroradiology Physician | 2085N0700X | D76040 | MD | |
| Diagnostic Radiology Physician | 2085R0202X | D76040 | MD | Yes |
Addresses
Primary practice location
22 S Greene St
Department of Radiology
Baltimore, MD 21201-1544
Mailing address
22 S Greene St
Department of Radiology
Baltimore, MD 21201-1544
Phone (410) 328-3477
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 017153386 | Medicaid | DC | |
| 414942401 | Medicaid | MD |
Other providers in Baltimore, MD
- Lydia Rafferty
- Megan Marie Rafferty
- Janet D. Raffetto
- Ishrat Z Rafi
- Martina M Raftery
- Preeti Raghavan
- Prithvi Raghavan
- Christina Raghunandan
- Ashrita Raghuram
- Ijee Amani Ragin
All providers in Baltimore, MD · Diagnostic Radiology Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.