Prasanna Suryadevar, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

52033 Issued in MN

Practice address

916 Saint Peter St
Delano, MN 55328-2813

Phone

(952) 442-7800

NPI assigned

May 28, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• St. Joseph'S Medical Center

  • Primary Care Clinic/Center
  • Pillager, MN
  • NPI 1891740957
  NPD (past)

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384473600000",
    "number": "1992930358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 SAINT PETER ST",
            "city": "DELANO",
            "state": "MN",
            "postal_code": "553282813",
            "telephone_number": "952-442-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 SAINT PETER ST",
            "city": "DELANO",
            "state": "MN",
            "postal_code": "553282813",
            "telephone_number": "952-442-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURYADEVAR",
        "first_name": "PRASANNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-28",
        "last_updated": "2013-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "52033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krystle Shane Smith, SLP
• Snyders Drug
• Dave A Socher
• Solace Counseling Associates Inc
• Melissa Lynn Spicer
• Courtney Synstegaard, CCC-SLP
• Heather Tesch
• The Legcy of Delano
• Elizabeth Margaret Thomas, MA LADC
• Thompson Chiropractic Clinic PA

• Internal Medicine Physician in Delano, MN
• Providers in Delano, MN by specialty
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.