Pranith Surabhi, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

41854 Issued in IA

Practice address

3135 W Broadway
Suite 100
Council Bluffs, IA 51501-3359

Phone

(712) 242-2040

Fax

(712) 325-2445

NPI assigned

Aug 8, 2011

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

Medicare fee-for-service enrollment

Enrolled in IA, NE2 enrollments

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 2

Specialty

Family Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alegent Creighton ClinicGroup PAC ID 1951210418, shared by 2 NPIs, 951 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060
• CHI Health Lakeside Hospital, Omaha, NE, CCN 280130

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Alegent Creighton Clinic

  • Family Medicine Physician
  • Council Bluffs, IA
  • NPI 1598811069
  Medicare reassignment NPD
• Alegent Creighton Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907
  Medicare reassignment NPD
• Alegent Creighton Clinic

  • Internal Medicine Physician
  • Omaha, NE
  • NPI 1154680700

  Family Medicine

  NPD (past)

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

• Alegent Creighton Health

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1649355132
  Care Compare affiliation
• Alegent Health Bergan Mercy Health System

  • Psychiatric Hospital Unit
  • Omaha, NE
  • NPI 1396969499
  Care Compare affiliation
• Alegent Health Bergan Mercy Health System

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1508941097
  Care Compare affiliation

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1891074803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3135 W BROADWAY",
            "address_2": "SUITE 100",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013359",
            "telephone_number": "712-242-2040",
            "fax_number": "712-325-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3135 W BROADWAY",
            "address_2": "SUITE 100",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013359",
            "telephone_number": "712-242-2040",
            "fax_number": "712-325-2445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURABHI",
        "first_name": "PRANITH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-08",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "41854",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "28025",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carey Stutzman
• Kaylee Stutzman
• Amber Dawn Sulley
• Tina Marie Sullivan
• Bradley Michael Sundsboe
• Gabrielle Sutton
• Dustin Otto Svatos, DDS
• Josalynn N Swan, P.A.
• Megan Sweeney, PHARM D
• Swfac PLC

• Family Medicine Physician in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; 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.