MS. PRAGATHI BALAKRISHNA M.D.
NPI 1295112118
Internal Medicine - Hematology & Oncology in Medford, OR

Q: What is Pragathi Balakrishna's NPI number?

The NPI number for Pragathi Balakrishna is 1295112118. It was assigned to this individual provider in the NPPES registry on April 29, 2015.

Q: What is Pragathi Balakrishna's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Active since April 29, 2015PECOS EnrolledAccepts Medicare Assignment

3011 E BARNETT RD, MEDFORD, OR 97504(541) 789-4673(541) 789-2121 Get Directions Write a Review

NPPES record last updated: January 17, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 17, 2022, Jun 25, 2021 (2 updates tracked since 2021).

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About Ms. Pragathi Balakrishna M.d. NPPES

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

MS. PRAGATHI BALAKRISHNA M.D. (NPI 1295112118) is an individual hematology & oncology provider in Medford, Oregon, licensed in Florida (21961) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS, is affiliated with Asante Three Rivers Medical Center, and maintains a secondary practice location in Grants Pass.

NPPES Registry Identity

NPI1295112118

Entity TypeIndividualFemale

Primary Taxonomy207RH0003X

Provider Legal NameMS. PRAGATHI BALAKRISHNACredential: M.D.

Location Address3011 E BARNETT RDMedford, OR 97504

Mailing AddressPo Box 4749Medford, OR 97501-0227 · (541) 789-4111 · Fax (541) 789-5518

Phone(541) 789-4673

Fax(541) 789-2121

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateApril 29, 2015

Last NPPES UpdateJanuary 17, 20222 updates tracked since enumeration

NPPES CertifiedJanuary 13, 2022

✔ NPI 1295112118 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

License✔ Licensed in FL · 21961

Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

3011 E BARNETT RD, Medford, OR 97504

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Secondary Practice Location 1

Location 1510 SW Ramsey AveGrants Pass, OR 97527-5554 · Phone (541) 789-4673 · Fax (541) 789-2121

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Providence Health Plan.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

Ms. Pragathi Balakrishna 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 ID5294142758

PECOS Enrollment IDI20210607003047

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 5

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.

470 services217 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

235 services110 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

66 services66 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.

58 services52 patients

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212

This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.

44 services38 patients

Hospital Affiliations CMS Care Compare 4

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

Asante Three Rivers Medical Center

Acute Care Hospitals · Grants Pass, OR

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number380002

Location500 SW Ramsey AvenueGrants Pass, OR 97527 · Josephine County

Emergency services Birthing friendly

Asante Ashland Community Hospital

Acute Care Hospitals · Ashland, OR

OwnershipGovernment - Local

CMS Certification Number380005

Location280 Maple StreetAshland, OR 97520 · Jackson County

Emergency services Birthing friendly

Asante Rogue Regional Medical Center

Acute Care Hospitals · Medford, OR

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380018

Location2825 E Barnett RoadMedford, OR 97504 · Jackson County

Emergency services Birthing friendly

Curry General Hospital

Critical Access Hospitals · Gold Beach, OR

OwnershipGovernment - Hospital District or Authority

CMS Certification Number381322

Location94220 Fourth StreetGold Beach, OR 97444 · Curry County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97504 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

$166.64 typical visit price

range $54.96 – $166.64

Typical copayment $41.66 (range $13.74 – $41.66)

Most-billed visit code 99205

Established Patient

$97.16 typical visit price

range $17.68 – $136.19

Typical copayment $24.29 (range $4.42 – $34.04)

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.

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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.

HEMATOLOGY ONCOLOGY ASSOCIATES, P.C.

Internal Medicine (Hematology & Oncology)