|Provider Name||DR. SUDHA R PRASAD MD|
|Location Address||3836 PARK AVE MEMPHIS, TN 38111|
|Location Phone||(901) 324-3984|
|Mailing Address||PO BOX 17962 MEMPHIS, TN 38187|
|NPI Entity Type||Individual|
|Medical School Name||OTHER|
|Is Sole Proprietor?||No|
|Last Update Date||03-22-2013|
A primary care provider (PCP) like Dr. Sudha R Prasad Md sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc Sudha Prasad is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Sudha Prasad is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data she has hospital affiliations with Baptist Memorial Hospital.
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.08 for a new patient copayment and $24.46 for an established patient copayment.
The CLIA number of Dr. Sudha R Prasad Md is 44D0314032 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Dr. Sudha R Prasad Md to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
|Type||Allopathic & Osteopathic Physicians|
|Taxonomy Description||Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.|
The NPI profile data indicates this provider might be enrolled and accepting insurance plans from the following companies or healthcare programs:
- Blue Cross Blue Shield
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
DR. SUDHA R PRASAD MD
3836 PARK AVE
Phone: (901) 324-3984
Fax: (901) 454-1655
DR. SUDHA R PRASAD MD
PO BOX 17962
Phone: (901) 324-3984
Fax: (901) 454-1655
PECOS Enrollment and Medicare Participation Status
What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
|Registered in PECOS?||Yes|
|PECOS PAC ID||7315027117|
|PECOS Enrollment ID||I20080107000375|
|Accepts Medicare Assignment?|| Yes "What does it mean "accepts medicare assignment"?|
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
|Eligible order / refer Part B Clinical Laboratory and Imaging||Yes|
|Eligible order / refer Durable Medical Equipment||Yes|
|Eligible order / refer Home Health Agency (HHA)||Yes|
|Eligible order / refer Power Mobility Devices||Yes|
Physician Office Visit Costs
The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 38111 ZIP code area.
|New Patients Office Visits Costs *|
|Most Utilized Procedure Code for new patients office visits: 99203|
|Minimum New Patient Pricing||Maximum New Patient Pricing||Typical New Patient Pricing|
|Minimum New Patient Copayment||Maximum New Patient Copayment||Typical New Patient Copayment|
|Established Patients Office Visits Costs *|
|Most Utilized Procedure Code for established patients office visits: 99214|
|Minimum Established Patient Pricing||Maximum Established Patient Pricing||Typical Established Patient Pricing|
|Minimum Established Patient Copayment||Maximum Established Patient Copayment||Typical Established Patient Copayment|
* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Sudha Prasad is affiliated with the following medical facilities:
|Hospital Name||Address||Phone||Hospital Type||CMS Certification Number (CCN)||Overall Rating|
|BAPTIST MEMORIAL HOSPITAL||6019 WALNUT GROVE ROAD|
MEMPHIS, TN 38120
|(901) 226-5000||Acute Care Hospitals||440048|
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1013083781 is:
|Facility Type||PHYSICIAN OFFICE|
|Certificate Type||Certificate of Waiver|
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
|Identifier||Type / Code||Identifier State||Identifier Issuer|
|3183447||MEDICARE ID-TYPE UNSPECIFIED (04)||TN|
|25923||OTHER (01)||TN||BLUE CROSS BLUE SHIELD|
|B04078||MEDICARE UPIN (02)||TN|
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
|Start with the original NPI number, the last digit is the check digit and is not used in the calculation.|
|Step 1: Double the value of the alternate digits, beginning with the rightmost digit.|
|Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.|
|2 + 0 + 2 + 3 + 0 + 8 + 6 + 7 + 1 + 6 + 24 = 59|
|Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.|
|60 - 59 = 1||1|
The NPI number 1013083781 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
Frequently Asked Questions
What is Dr. Sudha Prasad MD NPI number?
The NPI number assigned to Dr. Sudha Prasad MD is 1013083781, registered as an "individual" on November 27, 2006
Where is Dr. Sudha Prasad MD located?
The provider is located at 3836 Park Ave Memphis, Tn 38111 and the phone number is (901) 324-3984
Which is Dr. Sudha Prasad MD specialty?
The provider's speciality is Family Medicine
How many years of experience does Dr. Sudha Prasad MD have?
The provider has more than 49 years of experience.
What insurance does Dr. Sudha Prasad MD accept?
The provider might be accepting Blue Cross Blue Shield, Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your insurance plan is currently accepted.
Is Dr. Sudha Prasad MD registered in PECOS?
Yes, as of November 14, 2022 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
How much is a visit to Dr. Sudha Prasad MD?
Medicare beneficiaries should expect a typical cost of $84.32 with an average copayment of $21.08 for new patient appointments. Established patients should expect a typical charge of $97.84 and an average copayment of 24.46. Please review your insurance plan or contact the provider directly to determine your specific costs.
What is Dr. Sudha Prasad MD CLIA number?
The provider's CLIA number is 44D0314032 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
Is Dr. Sudha Prasad MD affiliated to any hospitals?
The practitioner is affiliated to the following hospitals: BAPTIST MEMORIAL HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
How do I update my NPI information?
The NPI record of Dr. Sudha Prasad MD was last updated on November 27, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]