Pranav Kumar Panchatsharam, DO

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

02007800A Issued in IN

Practice address

800 Broadway Ste 200
Fort Wayne, IN 46802-2149

Phone

(260) 458-3410

Fax

(260) 425-2881

NPI assigned

May 17, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Urology

Education

Campbell Univ School of Osteopathic Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Dupont Hospital LLC Hospital, Fort Wayne, IN, CCN 150150
• St Joseph Health System, LLC Hospital, Fort Wayne, IN, CCN 150047
• Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017
• Bluffton Regional Medical Center Hospital, Bluffton, IN, CCN 150075
• Kosciusko Community Hospital Hospital, Warsaw, IN, CCN 150133

Merit-based Incentive Payment System (MIPS)

Final score

90.99 of 100Reported as apm

Quality

77.41

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pranav.panchatsharam@lutheranhealthnetwork.cernerdirect.com

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.

• Lutheran Medical Group LLC

  • Cardiovascular Disease Physician
  • Fort Wayne, IN
  • NPI 1164662805
  Medicare reassignment Care Compare group NPD
• Lutheran Medical Group LLC

  • Durable Medical Equipment & Medical Supplies
  • Fort Wayne, IN
  • NPI 1710275664
  NPD

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

• Bluffton Health System LLC

  • General Acute Care Hospital
  • Bluffton, IN
  • NPI 1376594366
  Care Compare affiliation
• Dupont Hospital LLC

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1538110556
  Care Compare affiliation
• Iom Health System LP

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1306897335
  Care Compare affiliation
• St. Joseph Health System, LLC

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1023060472
  Care Compare affiliation
• Warsaw Health System LLC

  • General Acute Care Hospital
  • Warsaw, IN
  • NPI 1164475711
  Care Compare affiliation

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1851957526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-458-3410",
            "fax_number": "260-425-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BROADWAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468022149",
            "telephone_number": "260-458-3410",
            "fax_number": "260-425-2881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27351 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Madison Heights",
            "state": "MI",
            "postal_code": "480713487",
            "country_code": "US",
            "telephone_number": "248-967-7129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANCHATSHARAM",
        "first_name": "PRANAV",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-17",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IN",
            "license": "02007800A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pranav.panchatsharam@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "DM",
            "address_1": "800 Broadway Ste 200",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468022149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Heather Rochelle Palmer, MT-BC
• Leslie Palmer
• Scott L. Palmer, M.D.
• Srinivas R. Pamidi, MD
• Anthony Khuntong Panbamrung, PTA
• Pancner Psychiatric Associates, PC
• Ronald J Pancner, MD
• Suman Panday, DPT
• Shobana Pandian
• Vanessa Paniagua Rangel

• Urology Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Urology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.