PRAJWAL BASANNA KERANALLI MD
NPI 1043906894
Student in an Organized Health Care Education/Training Program in Saint Louis, MO

Active since April 14, 2023PECOS Enrolled
1201 S GRAND BLVD, SAINT LOUIS, MO 63104(314) 617-3749 Get Directions Write a Review

NPPES record last updated: April 24, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Prajwal Basanna Keranalli Md NPPES

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

PRAJWAL BASANNA KERANALLI MD (NPI 1043906894) is an individual student in an organized health care education/training program in Saint Louis, Missouri and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043906894
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NamePRAJWAL BASANNA KERANALLICredential: MD
Location Address1201 S GRAND BLVDSaint Louis, MO 63104-1016
Mailing Address105 Sweet Cherry WayWildwood, MO 63040-2146 · (301) 728-9565
Sole ProprietorNo
Enumeration DateApril 14, 2023
Last NPPES UpdateApril 24, 2023
NPPES CertifiedApril 24, 2023
NPI 1043906894 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1201 S GRAND BLVD, Saint Louis, MO 63104

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Prajwal Basanna Keranalli Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 20

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

Nurse Practitioner (Acute Care)
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
Student in an Organized Health Care Education/Training Program
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
Hospitalist
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
Student in an Organized Health Care Education/Training Program
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
Physician Assistant
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
Student in an Organized Health Care Education/Training Program
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
Pediatrics
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
Hospitalist
1201 S GRAND BLVD
SAINT LOUIS, MO 63104

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 Prajwal Keranalli's NPI number?

The NPI number for Prajwal Keranalli is 1043906894. It was assigned to this individual provider in the NPPES registry on April 14, 2023.

Where is Prajwal Keranalli located?

Prajwal Keranalli practices at 1201 S Grand Blvd, Saint Louis, MO 63104. The listed phone number is (314) 617-3749.

What is Prajwal Keranalli's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Prajwal Keranalli enrolled in Medicare?

Yes. Prajwal Keranalli is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Prajwal Keranalli was last updated on April 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.