Individual provider Active NPI

Pranathi Lingam, M.D.

  • Dermatology Physician
  • Edmond, OK
National Provider Identifier
1821324963
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
37247 Issued in OK
Practice address
1354 E 15TH St
Edmond, OK 73013-5029
Phone
(405) 285-8823
NPI assigned
Oct 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X P6859 TX
Internal Medicine Physician 207R00000X BP10034494 TX
Internal Medicine Physician 207R00000X 37247 OK
Dermatology Physician 207N00000X 37247 OK Primary

Addresses

Primary practice location

1354 E 15TH St
Edmond, OK 73013-5029

Mailing address

14024 Quail Pointe Dr
Oklahoma City, OK 73134-1006
Phone (405) 419-8465

Other identifiers 1

IdentifierTypeStateIssuer
.Other.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210504002189 OK Practitioner - Dermatology 8527368869 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Alabama School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heritage Health Services LLCGroup PAC ID 7214314111, 15 clinicians

Practice addresses (Care Compare)

6516 N Olie Ave
Suite G
Oklahoma City, OK 73116-7399
Phone (405) 608-8060

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions790
Removal or shaving of skin growth1-10
Skin biopsy182

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10034494TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Health Services LLC CurrentSince Aug 1, 2024 Accepting new patients
The Physicians Group LLC Internal Medicine CurrentSince Jun 17, 2021 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

1616 S Kelly Ave
Edmond, OK 73013
Phone (405) 330-0015

1354 E 15th St
Edmond, OK 73013
Phone (405) 285-8823

10021 S Western Ave
Oklahoma City, OK 73139
Phone (405) 692-9300

14024 Quail Pointe Dr
Oklahoma City, OK 73134
Phone (405) 419-8447

6516 N Olie Ave
Ste G
Oklahoma City, OK 73116
Phone (405) 608-8060

Interoperability endpoints

  • Direct secure messaging: plingam@spectrumdermokc.emadirect.md

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1256428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1821324963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14024 QUAIL POINTE DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341006",
            "telephone_number": "405-419-8465",
            "fax_number": "405-419-7745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1354 E 15TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135029",
            "telephone_number": "405-285-8823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINGAM",
        "first_name": "PRANATHI",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-25",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "P6859",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10034494",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "37247",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OK",
            "license": "37247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": ".",
            "identifier": ".",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.