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

Q: 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.

Q: What is Prita Tandyasraya's specialty?

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

Q: 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 4 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.

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: August 02, 2026.

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

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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

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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, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).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

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.

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 Heart Of Florida

Acute Care Hospitals · Davenport, FL

1/5 CMS rating

OwnershipProprietary

CMS Certification Number100137

Location40100 Hwy 27Davenport, FL 33837 · Polk 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