NPIMap

Individual provider Active NPI

Roshan Sudhir Prabhu, M.D.

  • Radiation Oncology Physician
  • Charlotte, NC
National Provider Identifier
1871751420
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
2013-00525 Issued in NC
Practice address
1021 Morehead Medical Dr
Charlotte, NC 28204-2839
Phone
(704) 333-7376
Fax
(704) 333-3397
NPI assigned
May 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Radiation Oncology Physician 2085R0001X 2013-00525 NC Primary

Addresses

Primary practice location

1021 Morehead Medical Dr
Charlotte, NC 28204-2839

Mailing address

200 Queens Rd
Suite 400
Charlotte, NC 28204-3253
Phone (704) 333-7376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 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
I20130627000896 NC Practitioner - Radiation Oncology 7113167933 Reassigns benefits to 2 organizations
I20130801000537 SC Practitioner - Radiation Oncology 7113167933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Florida College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southeast Radiation Oncology Group, P.a.Group PAC ID 1254233950, 52 clinicians

Practice addresses (Care Compare)

1005 W Meeting St
Lancaster, SC 29720-2205
Phone (803) 283-6200

200 Queens Rd
Charlotte, NC 28204-3264
Phone (704) 333-7376

301 Yadkin St
Albemarle, NC 28001-3441
Phone (704) 333-7376

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013-00525NCMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiation Oncology Centers of the Carolinas, Inc. Radiation Oncology CurrentSince Jul 15, 2013 Accepting new patients
Southeast Radiation Oncology Group, P.a. Radiation Oncology CurrentSince Jul 15, 2013 Accepting new patients
Piedmont Carolinas Radiation Therapy LLC Current Accepting new patients
Piedmont Carolinas Radiation Therapy LLC CurrentSince Jul 15, 2013 Accepting new patients
Radiation Oncology Centers of the Carolinas, Inc. Radiation Oncology CurrentSince Jul 15, 2013 Accepting new patients
University Radiation Therapy Center Past Accepting new patients
Pineville Radiation Therapy Center, LLC Past Accepting new patients

Locations

200 Queens Rd
Ste 400
Charlotte, NC 28204
Phone (704) 765-2578

1021 Morehead Medical Dr
Charlotte, NC 28204
Phone (704) 355-2272

8310 University Exec Park Dr
Ste 500
Charlotte, NC 28262
Phone (704) 547-8762

1400 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 845-8800

170 Medical Park Rd
Ste 100
Mooresville, NC 28117
Phone (704) 235-2580

1005 W Meeting St
Lancaster, SC 29720
Phone (803) 283-6200

228 Herlong Ave S
Rock Hill, SC 29732
Phone (803) 366-5186

Interoperability endpoints

  • Direct secure messaging: rprabhu137235@carolinashealthcaresystem.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 12

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": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1871751420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 QUEENS RD",
            "address_2": "SUITE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043253",
            "telephone_number": "704-333-7376",
            "fax_number": "704-333-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 MOREHEAD MEDICAL DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042839",
            "telephone_number": "704-333-7376",
            "fax_number": "704-333-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRABHU",
        "first_name": "ROSHAN",
        "middle_name": "SUDHIR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-30",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NC",
            "license": "2013-00525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.