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TRIKANNAD S PRASHANTHKUMAR MD
NPI 1023067428
Internal Medicine - Endocrinology, Diabetes & Metabolism in Sidney, OH

Active since May 10, 2006PECOS EnrolledAccepts Medicare Assignment
84.78/100
CMS Quality Rating
915 MICHIGAN ST STE 100, SIDNEY, OH 45365(937) 498-5384(937) 492-8093 Get Directions Write a Review

NPPES record last updated: December 16, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Trikannad S Prashanthkumar Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRIKANNAD S PRASHANTHKUMAR MD (NPI 1023067428) is an individual endocrinology, diabetes & metabolism provider in Sidney, Ohio, licensed in Ohio (35-071509) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Lima Memorial Health System, and is a graduate of Other (1984).

NPPES Registry Identity

NPI1023067428
Entity TypeIndividualMale
Primary Taxonomy207RE0101X
Provider Legal NameTRIKANNAD S PRASHANTHKUMARCredential: MD
Location Address915 MICHIGAN ST STE 100Sidney, OH 45365-2401
Mailing Address915 West Michigan StSidney, OH 45365-2401 · (937) 498-5384 · Fax (937) 492-8093
Phone(937) 498-5384
Fax(937) 492-8093
Sole ProprietorNo
Medical School CMSOtherGraduated 1984
Enumeration DateMay 10, 2006
Last NPPES UpdateDecember 16, 2020
NPPES CertifiedDecember 2, 2020
✔ NPI 1023067428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in OH · 35-071509
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
915 MICHIGAN ST STE 100, Sidney, OH 45365
Open in Google Maps ↗

Other Identifiers 1

Medicaid2003852OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Trikannad S Prashanthkumar Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1153382031
PECOS Enrollment IDI20041025000001
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
365 services220 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
361 services255 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
325 services149 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
307 services180 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
65 services65 patients
Blood glucose (sugar) test performed by hand-held instrument 82962
A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.
11 services11 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lima Memorial Health System

Acute Care Hospitals · Lima, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number360009
Location1001 Bellefontaine AvenueLima, OH 45804 · Allen County
Emergency services Birthing friendly

Wilson Memorial Hospital

Acute Care Hospitals · Sidney, OH
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360013
Location915 West Michigan StreetSidney, OH 45365 · Shelby County
Emergency services Birthing friendly

Grand Lake Health System

Acute Care Hospitals · Saint Marys, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360032
Location200 Saint Clair StreetSaint Marys, OH 45885 · Auglaize County
Emergency services Birthing friendly

Mercer County Joint Township Community Hospital

Acute Care Hospitals · Coldwater, OH
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number360058
Location800 West Main StreetColdwater, OH 45828 · Mercer County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45365 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality75.09
Promoting Interoperability100
Improvement Activities40
Cost74.18

Referred Medical Equipment & Supplies CMS DME claims 10

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supplies for maintenance of insulin infusion catheter, per week A4224
DME-Other DME · category DE017N
8 suppliers89 claims1,134 services$18.47 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
7 suppliers77 claims2,348 services$2.32 avg. paid by Medicare
Supply allowance for adjunctive continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service A4238
DME-Medical/Surgical Supplies · category DA000N
1 supplier11 claims11 services$175.65 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
29 suppliers236 claims733 services$6.01 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
3 suppliers12 claims12 services$2.68 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
16 suppliers46 claims78 services$1.08 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LAURIE A NIELSEN-HAAK DPM
Podiatrist (Foot & Ankle Surgery)
915 MICHIGAN ST STE 100
SIDNEY, OH 45365
Shelby County (937) 419-8049
TRENTON WOLFE DPM
Podiatrist (Foot & Ankle Surgery)
915 MICHIGAN ST STE 100
SIDNEY, OH 45365
Shelby County (937) 419-8049

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Trikannad Prashanthkumar's NPI number?

The NPI number for Trikannad Prashanthkumar is 1023067428. It was assigned to this individual provider in the NPPES registry on May 10, 2006.

Where is Trikannad Prashanthkumar located?

Trikannad Prashanthkumar practices at 915 Michigan St Ste 100, Sidney, OH 45365. The listed phone number is (937) 498-5384.

What is Trikannad Prashanthkumar's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Trikannad Prashanthkumar enrolled in Medicare?

Yes. Trikannad Prashanthkumar is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Trikannad Prashanthkumar accept?

Health plans from Anthem Blue Cross and Blue Shield list Trikannad Prashanthkumar as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Trikannad Prashanthkumar affiliated with any hospitals?

According to CMS data, Trikannad Prashanthkumar is affiliated with Lima Memorial Health System, Wilson Memorial Hospital, Grand Lake Health System and Mercer County Joint Township Community Hospital.

When was this NPI record last updated?

The NPPES record for Trikannad Prashanthkumar was last updated on December 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.