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PRITA TANDYASRAYA M.D.
NPI 1144754979
Psychiatry & Neurology - Neurology in Nellis Afb, NV

Active since April 19, 2017PECOS EnrolledAccepts Medicare Assignment
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191(702) 653-3244(702) 653-2378 Get Directions Write a Review

NPPES record last updated: March 16, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 16, 2026, Nov 3, 2023, Aug 3, 2021 and 1 more (4 updates tracked since 2017).

About Prita Tandyasraya M.d. NPPES

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

PRITA TANDYASRAYA M.D. (NPI 1144754979) is an individual neurology provider in Nellis Afb, Nevada, licensed in Arizona (R76053) and active in the NPI registry since April 2017. She is enrolled in Medicare PECOS, is affiliated with Adventhealth Orlando, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1144754979
Entity TypeIndividualFemale
Primary Taxonomy2084N0400X
Provider Legal NamePRITA TANDYASRAYACredential: M.D.
Location Address4700 LAS VEGAS BLVD NNellis Afb, NV 89191-6600
Mailing Address4700 Las Vegas Blvd NNellis Afb, NV 89191-6600 · (702) 653-3244 · Fax (702) 653-2378
Phone(702) 653-3244
Fax(702) 653-2378
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateApril 19, 2017
Last NPPES UpdateMarch 16, 20264 updates tracked since enumeration
NPPES CertifiedMarch 16, 2026
✔ NPI 1144754979 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
Licenses✔ Licensed in AZ · R76053✔ Licensed in AZ · 63541✔ Licensed in FL · ME165558
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
4700 LAS VEGAS BLVD N, Nellis Afb, NV 89191
Open in Google Maps ↗

Secondary Practice Locations 2

Location 12400 S Avenue AYuma, AZ 85364-7127 · Phone (928) 344-2000
Location 211215 Metro Pkwy Ste 100Fort Myers, FL 33966-1206 · Phone (239) 208-2212

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CHRISTUS Health Plan, Cigna HealthCare of Arizona, Inc, Florida Blue (BlueCross BlueShield FL) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Prita Tandyasraya M.d. 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 ID7214291442
PECOS Enrollment IDI20231213002880, I20231229001270, I20240325000671
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Prita Tandyasraya reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Virtual Neurology Texas PLLC
1,063 mi
Neurology
320 DECKER DR
Irving, TX 75062
  • Reassigned Medicare billing, Arizona enrollment
  • 6 clinicians in this Medicare group
NPI 1467092114 (239) 208-2212
Virtual Neurology, LLC
2,065 mi
Neurology
11215 METRO PKWAY, BLDG. 3, STE 1
Fort Myers, FL 33966
  • Reassigned Medicare billing, Arizona and Nevada enrollments
  • 5 clinicians in this Medicare group
NPI 1760940167 (392) 082-2122
Landmark Hospital Of Southwest Florida, LLC
2,074 mi
Long Term Care Hospital
1500 LEE BLVD FL 3
Lehigh Acres, FL 33936
  • Reassigned Medicare billing, Florida enrollment
  • Medicare enrollment name: Nchmd Inc
  • 808 clinicians in this Medicare group
NPI 1932595659 (573) 331-8412

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

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.

Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth G0508
A telehealth consultation for critical care is a virtual meeting with a physician, typically lasting 60 minutes. Here, the doctor assesses your health condition, provides guidance, and communicates with other care providers, all through digital platforms. It's a safe, convenient way to receive critical care.
12 services12 patients

Hospital Affiliations CMS Care Compare 5

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

Adventhealth Orlando

Acute Care Hospitals · Orlando, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100007
Location601 E Rollins StOrlando, FL 32803 · Orange County
Emergency services Birthing friendly

Adventhealth Waterman

Acute Care Hospitals · Tavares, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number100057
Location1000 Waterman WayTavares, FL 32778 · Lake County
Birthing friendly

Adventhealth Daytona Beach

Acute Care Hospitals · Daytona Beach, FL
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number100068
Location301 Memorial Medical ParkwayDaytona Beach, FL 32117 · Volusia County
Emergency services Birthing friendly

Christus Spohn Hospital Corpus Christi

Acute Care Hospitals · Corpus Christi, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450046
Location600 Elizabeth StreetCorpus Christi, TX 78404 · Nueces County
Emergency services Birthing friendly

Christus St Michael Health System

Acute Care Hospitals · Texarkana, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number450801
Location2600 St Michael DrTexarkana, TX 75503 · Bowie County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89191 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
$131.25 typical visit price
range $57.07 – $173.24
Typical copayment $32.81 (range $14.26 – $43.31)
Most-billed visit code 99204
Established Patient
$100.60 typical visit price
range $18.27 – $140.96
Typical copayment $25.15 (range $4.56 – $35.24)
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.

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.

DR. DEBRA A KOENIGSBERGER MD
Integrative Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2267
KATRINA BAUMANN DPT
Physical Therapist (Orthopedic)
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2273
SOUKAINA NOOR MD
Psychiatry & Neurology (Neurology)
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2273
EDWARD KEMPTON MD
Emergency Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2273
DR. AARON JOSEPH WOLBRUECK DO
Internal Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2273
MARIA M ARAQUE PHARMD
Pharmacist
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-3202
DR. SHUBHANG N MAZUMDAR M.D.
Internal Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-3800
CYNTHIA SCHMIDT PH.D.
Psychologist (Clinical)
4700 LAS VEGAS BLVD N, ATTN: CREDENTIALS OFFICE
NELLIS AFB, NV 89191
Clark County (702) 653-3067

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 Prita Tandyasraya's NPI number?

The NPI number for Prita Tandyasraya is 1144754979. It was assigned to this individual provider in the NPPES registry on April 19, 2017.

Where is Prita Tandyasraya located?

Prita Tandyasraya practices at 4700 Las Vegas Blvd N, Nellis Afb, NV 89191. The listed phone number is (702) 653-3244.

What is Prita Tandyasraya's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Prita Tandyasraya enrolled in Medicare?

Yes. Prita Tandyasraya 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.

Which organizations bill Medicare for Prita Tandyasraya's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Prita Tandyasraya reassigns Medicare benefits to 3 organizations: Virtual Neurology Texas PLLC (Irving, TX), Virtual Neurology, LLC (Fort Myers, FL) and Landmark Hospital Of Southwest Florida, LLC (Lehigh Acres, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Prita Tandyasraya's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Prita Tandyasraya accept?

Health plans from CHRISTUS Health Plan, Cigna HealthCare of Arizona, Inc, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Prita Tandyasraya 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 Prita Tandyasraya affiliated with any hospitals?

According to CMS data, Prita Tandyasraya is affiliated with Adventhealth Orlando, Adventhealth Waterman, Adventhealth Daytona Beach, Christus Spohn Hospital Corpus Christi and Christus St Michael Health System.

When was this NPI record last updated?

The NPPES record for Prita Tandyasraya was last updated on March 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.