NPIMap

Individual provider Active NPI

Prashant Raghavan, M.D.

  • Diagnostic Radiology Physician
  • Baltimore, MD
National Provider Identifier
1740339787
Registry record updated Apr 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
D76040 Issued in MD
Practice address
22 S Greene St
Department of Radiology
Baltimore, MD 21201-1544
Phone
(410) 328-3477
NPI assigned
Jan 9, 2007
Last updated
Apr 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X D76040 MD
Diagnostic Radiology Physician 2085R0202X D76040 MD Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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
I20130913000689 MD Practitioner - Diagnostic Radiology 4082637400 Reassigns benefits to 3 organizations
I20181210003256 DC Practitioner - Diagnostic Radiology 4082637400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Imaging Center, LLCGroup PAC ID 2769378686, 56 clinicians

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Diagnostic Imaging Specialists P a Neuroradiology CurrentSince Aug 1, 2013 Accepting new patients
University Imaging Center, LLC Neuroradiology CurrentSince Aug 1, 2013 Accepting new patients
University of Maryland Diagnostic Radiology, LLC Neuroradiology CurrentSince Jul 8, 2017 Accepting new patients
University of Maryland Diagnostic Radiology, LLC Neuroradiology CurrentSince Jul 8, 2017 Accepting new patients
University of Maryland Diagnostic Imaging Specialists P a Neuroradiology CurrentSince Aug 1, 2013 Accepting new patients
University Imaging Center, LLC Neuroradiology CurrentSince Aug 1, 2013 Accepting new patients
University of Virginia Physicians Group PastSince Nov 1, 2017 Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

22 S Greene St
Rm N2E23
Baltimore, MD 21201
Phone (410) 328-5656

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

  • Direct secure messaging: praghavan85190@direct.umm.edu

Organizations & group practices 7

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 5

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556236800000",
    "number": "1740339787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-3477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-3477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGHAVAN",
        "first_name": "PRASHANT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2019-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MD",
            "license": "D76040",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D76040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.