Individual provider Active NPI

Pranav Raghunath Prabhu, PA

  • Medical Physician Assistant
  • Rochester, NY
National Provider Identifier
1972850436
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
015786 Issued in NY
Practice address
1555 Long Pond Rd
Department of Medicine
Rochester, NY 14626-4122
Phone
(585) 723-7870
Fax
(585) 723-7871
NPI assigned
Aug 14, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 15786 NY
Medical Physician Assistant 363AM0700X 015786 NY Primary

Addresses

Primary practice location

1555 Long Pond Rd
Department of Medicine
Rochester, NY 14626-4122

Mailing address

1555 Long Pond Rd
Department of Medicine
Rochester, NY 14626-4122
Phone (585) 723-7870

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address pprabhu47260@direct.urmc.rochester.edu Direct
Direct Messaging Address pprabhu47260@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120919000051 NY Practitioner - Physician Assistant 4789832684 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hematology Clinical GroupGroup PAC ID 4486618576, 80 clinicians
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 275-6687

601 Elmwood Ave
Rochester, NY 14642-0002
Phone (585) 275-2100

738 Library Rd
Rochester, NY 14642-0001
Phone (585) 275-2638

Hospital & facility affiliations

  • Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15786NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Jan 1, 2019 Accepting new patients
University of Rochester CurrentSince Jan 1, 2019 Accepting new patients
The Unity Hospital of Rochester CurrentSince Aug 13, 2012 Accepting new patients
Internal Medicine Group CurrentSince Mar 30, 2024 Accepting new patients

Locations

601 Elmwood Ave
#704
Rochester, NY 14642
Phone (585) 275-5823

601 Elmwood Ave
#610
Rochester, NY 14642
Phone (585) 275-2881

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Interoperability endpoints

  • Direct secure messaging: pprabhu47260@direct.urmc.rochester.edu

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 2

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": "1344902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1972850436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 LONG POND RD",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264122",
            "telephone_number": "585-723-7870",
            "fax_number": "585-723-7871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 LONG POND RD",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264122",
            "telephone_number": "585-723-7870",
            "fax_number": "585-723-7871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRABHU",
        "first_name": "PRANAV",
        "middle_name": "RAGHUNATH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-14",
        "last_updated": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "15786",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "015786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pprabhu47260@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pprabhu47260@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.