PRASHANT NAGPAL M.D.
NPI 1255763579
Radiology - Diagnostic Radiology in Madison, WI

NPI Status: Active since August 09, 2013

Contact Information

600 HIGHLAND AVE
MADISON, WI
ZIP 53792
Phone: (608) 263-9729

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  • Individual
  • Male
  • Years of Experience 18
  • Radiology
  • Diagnostic Radiology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About PRASHANT NAGPAL

This page provides the complete NPI Profile along with additional information for Prashant Nagpal, a provider established in Madison, Wisconsin with a medical specialization in Radiology, focusing in diagnostic radiology and more than 18 years of experience. The healthcare provider is registered in the NPI registry with number 1255763579 assigned on August 2013. The practitioner's primary taxonomy code is 2085R0202X with license number 20357 (WI). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI
1255763579
Provider Name
PRASHANT NAGPAL M.D.
Gender
Male
Entity Type
Individual
Location Address
600 HIGHLAND AVE MADISON, WI 53792
Location Phone
(608) 263-9729
Mailing Address
7974 UW HEALTH CT MIDDLETON, WI 53562
Medical School Name
OTHER
Graduation Year
2008
Is Sole Proprietor?
No
Enumeration Date
08-09-2013
Last Update Date
05-03-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Radiology Diagnostic Radiology

Taxonomy Code
2085R0202X
Type
Allopathic & Osteopathic Physicians
License No.
20357
License State
WI
Taxonomy Description
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
12085R0202XAllopathic & Osteopathic Physicians

Radiology
Diagnostic Radiology

R-10209 (IA)
22085R0202XAllopathic & Osteopathic Physicians

Radiology
Diagnostic Radiology

MD-45122 (IA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Better Together HMO Bronze 6500 Ded/8750 MOOP HSA - HMO
  • Better Together HMO Bronze 7500 Ded/10000 MOOP HSA - HMO
  • Better Together HMO Bronze No Medical Ded/10600 MOOP HSA - HMO
  • Better Together HMO Gold 1500 Ded/8000 MOOP with Vision - HMO
  • Better Together HMO Gold 2000 Ded/8200 MOOP - HMO
  • Better Together HMO Gold 4000 Ded/4000 MOOP HSA - HMO
  • Better Together HMO Platinum 750 Ded/2000 MOOP with Vision - HMO
  • Better Together HMO Platinum No Ded/3300 MOOP - HMO
  • Better Together HMO Platinum No Ded/5200 MOOP - HMO
  • Better Together HMO Silver 5500 Ded/8500 MOOP with Vision - HMO
  • Better Together HMO Silver 5975 Ded/5975 MOOP HSA - HMO
  • Better Together HMO Silver 6000 Ded/8900 MOOP - HMO
  • Partners HMO Bronze 10600 Ded/10600 MOOP HSA - HMO
  • Partners HMO Bronze 6000 Ded/10600 MOOP HSA - HMO
  • Partners HMO Bronze 7500 Ded/10000 MOOP HSA - HMO
  • Partners HMO Gold 1500 Ded/8000 MOOP with Vision - HMO
  • Partners HMO Gold 2000 Ded/8200 MOOP - HMO
  • Partners HMO Gold 4000 Ded/4000 MOOP HSA - HMO
  • Partners HMO Silver 5500 Ded/8500 MOOP with Vision - HMO
  • Partners HMO Silver 5975 Ded/5975 MOOP HSA - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Prashant Nagpal is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Prashant Nagpal 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.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 4284861782

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20210511002048

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • 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 to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Ct scan of abdominal aorta and both leg arteries with contrast

A CT scan of the abdominal aorta and both leg arteries with contrast is a medical imaging procedure. A special dye is injected to make your blood vessels visible on the scan. This helps to check for any blockages or abnormalities in these areas.

This service was performed 20 times for 20 patients

Ct scan of blood vessels and grafts of heart with contrast

A CT scan of the heart's blood vessels and grafts with contrast is a diagnostic test. A special dye (contrast) is injected into your veins, which helps create clear images of your heart's vessels and grafts. This helps doctors detect blockages or other abnormalities.

This service was performed 26 times for 26 patients

Ct scan of blood vessels of abdomen and pelvis with contrast

A CT scan of the abdomen and pelvis with contrast is a medical imaging procedure. A special dye, called contrast, is used to make blood vessels more visible. The scan produces detailed images of your abdomen and pelvis, helping doctors to diagnose conditions or plan treatments.

This service was performed 73 times for 71 patients

Ct scan of blood vessels of abdomen and pelvis with contrast

A CT scan of the abdomen and pelvis with contrast is a medical imaging procedure. A special dye, called contrast, is used to make blood vessels more visible. The scan produces detailed images of your abdomen and pelvis, helping doctors to diagnose conditions or plan treatments.

This service was performed 19 times for 19 patients

Ct scan of blood vessels of chest with contrast

A CT scan of the chest with contrast is a non-invasive imaging test. It uses X-rays and a special dye to get detailed images of your blood vessels in the chest. This helps in diagnosing conditions related to heart and lungs.

This service was performed 209 times for 208 patients

Ct scan of blood vessels of chest with contrast

A CT scan of the chest with contrast is a non-invasive imaging test. It uses X-rays and a special dye to get detailed images of your blood vessels in the chest. This helps in diagnosing conditions related to heart and lungs.

This service was performed 28 times for 28 patients

Ct scan of chest with contrast

A CT scan of the chest with contrast is an imaging procedure. A special dye (contrast) is used to highlight specific areas in your body, providing clearer pictures of your chest. This helps in diagnosing conditions related to your lungs, heart, and other chest structures.

This service was performed 53 times for 53 patients

Ct scan of chest with contrast

A CT scan of the chest with contrast is an imaging procedure. A special dye (contrast) is used to highlight specific areas in your body, providing clearer pictures of your chest. This helps in diagnosing conditions related to your lungs, heart, and other chest structures.

This service was performed 18 times for 18 patients

Ct scan of chest without contrast

A CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.

This service was performed 154 times for 152 patients

Ct scan of chest without contrast

A CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.

This service was performed 76 times for 76 patients

Ct scan of heart structure with contrast

A CT scan of the heart with contrast is a non-invasive test. A dye is injected into your veins, which helps to highlight heart structures in the images. The CT scanner uses X-rays to create detailed pictures of your heart, aiding in diagnosis.

This service was performed 28 times for 27 patients

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml

Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.

This service was performed 5,065 times for 47 patients

Mri scan of blood vessels of abdomen

An MRI scan of the abdomen's blood vessels, known as an abdominal MR angiography, is a non-invasive imaging test. It uses magnetic fields and radio waves to provide detailed images of your blood vessels. This aids in diagnosing issues like blockages or aneurysms.

This service was performed 11 times for 11 patients

Mri scan of blood vessels of chest

An MRI scan of the chest blood vessels is a non-invasive imaging procedure. It uses a magnetic field and radio waves to create detailed images of the vessels in your chest. This helps in detecting any abnormalities or diseases. It's a safe procedure with minimal discomfort.

This service was performed 19 times for 19 patients

Mri scan of blood vessels of pelvis

An MRI scan of the pelvic blood vessels is a non-invasive imaging procedure. It uses magnetic fields and radio waves to create detailed pictures of the vessels in your lower abdomen. This helps doctors check for issues like blockages or abnormalities.

This service was performed 11 times for 11 patients

Mri scan of heart before and after contrast

An MRI scan of the heart with contrast is a non-invasive imaging test. It uses magnetic fields and radio waves to create detailed pictures of your heart. The contrast dye improves the clarity of these images. This test helps in diagnosing heart conditions.

This service was performed 46 times for 46 patients

X-ray of chest, 1 view

A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.

This service was performed 766 times for 616 patients

X-ray of chest, 2 views

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

This service was performed 303 times for 294 patients

X-ray of chest, 2 views

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

This service was performed 43 times for 43 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $20.73 for a new patient copayment and $16.84 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 53792 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $82.92
  • Minimum New Patient Price $53.9
  • Maximum New Patient Price $163.24
  • Average New Patient Copayment $20.73
  • Minimum New Patient Copayment $13.47
  • Maximum New Patient Copayment $40.81

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $67.37
  • Minimum Established Patient Price $17.4
  • Maximum Established Patient Price $133.76
  • Average Established Patient Copayment $16.84
  • Minimum Established Patient Copayment $4.35
  • Maximum Established Patient Copayment $33.44

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical 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. Prashant Nagpal is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY600 HIGHLAND AVENUE
MADISON, WI 53792
(608) 263-6400Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1255763579, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
5
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
6
Unchanged
Pos 7
3
Doubled → 6
Pos 8
5
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 7 → 14 → 5 3 → 6 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 0 + 5 + 1 + 4 + 6 + 6 + 5 + 1 + 4 + 24 = 61

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1255763579.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Emergency Medicine
600 HIGHLAND AVE
MADISON, WI 53792
Radiology (Diagnostic Radiology)
600 HIGHLAND AVE
MADISON, WI 53792
Neurological Surgery
600 HIGHLAND AVE
MADISON, WI 53792
Psychiatry & Neurology (Neurology)
600 HIGHLAND AVE
MADISON, WI 53792
Psychiatry & Neurology (Neurology)
600 HIGHLAND AVE
MADISON, WI 53792
Nurse Practitioner
600 HIGHLAND AVE
MADISON, WI 53792
Radiology (Diagnostic Radiology)
600 HIGHLAND AVE
MADISON, WI 53792
Physician Assistant
600 HIGHLAND AVE
MADISON, WI 53792
Nurse Anesthetist, Certified Registered
600 HIGHLAND AVE
MADISON, WI 53792
Radiology (Radiation Oncology)
600 HIGHLAND AVE
MADISON, WI 53792
Anesthesiology
600 HIGHLAND AVE
MADISON, WI 53792
Anesthesiology
600 HIGHLAND AVE
MADISON, WI 53792
Anesthesiology
600 HIGHLAND AVE
MADISON, WI 53792
Nurse Anesthetist, Certified Registered
600 HIGHLAND AVE
MADISON, WI 53792
Nurse Anesthetist, Certified Registered
600 HIGHLAND AVE
MADISON, WI 53792
Nurse Anesthetist, Certified Registered
600 HIGHLAND AVE
MADISON, WI 53792
Nurse Anesthetist, Certified Registered
600 HIGHLAND AVE
MADISON, WI 53792
Anesthesiology
600 HIGHLAND AVE
MADISON, WI 53792
Anesthesiology
600 HIGHLAND AVE
MADISON, WI 53792
Internal Medicine (Medical Oncology)
600 HIGHLAND AVE
MADISON, WI 53792

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1255763579, enumerated as an "individual" on August 09, 2013.

The provider is located at 600 HIGHLAND AVE MADISON, WI 53792 and the phone number is (608) 263-9729.

Radiology with taxonomy code 2085R0202X and a focus in Diagnostic Radiology.

The provider might be accepting Accepts: Group Health Cooperative-SCW. Please consult your insurance carrier or call the provider to verify.

Prashant Nagpal is affiliated with: UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY.