Hosamane S Prabhakara, MD

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

042394 Issued in GA

Practice address

300 East Hospital Road
Eishenhower Medical Ctr
Fort Gordon, GA 30905-5650

Phone

(706) 787-9123

NPI assigned

Feb 10, 2006

Last updated

Apr 23, 2024By the provider in NPPES

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 GA

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

Specialty

Allergy/ImmunologyAlso: Pediatric Medicine

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Asthma Allergy and Immunology Clinic LLC

  • Allergy & Immunology Physician
  • Stockbridge, GA
  • NPI 1154080786
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1851364749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "756 PENINSULA OVERLOOK",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302286062",
            "telephone_number": "229-869-0756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 EAST HOSPITAL ROAD",
            "address_2": "EISHENHOWER MEDICAL CTR",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055650",
            "telephone_number": "706-787-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRABHAKARA",
        "first_name": "HOSAMANE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2024-04-23",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "042394",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "GA",
            "license": "042394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00758458A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Denise Poole
• Clyte Lydia Portis, LCSW, LISW-CP
• David Merica Powell, OTR
• Tyler Alexander Powell, M.D.
• Beth R Powers, RDH
• Christopher Shane Pritchard
• Dan Melbourne Prucha, DDS
• Quinnon Ralph Purvis, M.D.
• Helen Minnetta Putnam, OTRL, PA
• Jacques R Pye, MD

• Allergy & Immunology Physician in Fort Gordon, GA
• Providers in Fort Gordon, GA by specialty
• Allergy & Immunology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.