PRATHIBHA POTHARLANKA M.D.
NPI 1295761690
Hospitalist in Willingboro, NJ

Active since June 25, 2006PECOS EnrolledAccepts Medicare Assignment
87.02/100
CMS Quality Rating
218 SUNSET RD, WILLINGBORO, NJ 08046(609) 835-2900(856) 566-2797 Get Directions Write a Review

NPPES record last updated: September 6, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Prathibha Potharlanka M.d. NPPES

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

PRATHIBHA POTHARLANKA M.D. (NPI 1295761690) is an individual hospitalist provider in Willingboro, New Jersey, licensed in New Jersey (25MA07690100) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS, is affiliated with University Medical Center Of Princeton At Plainsboro, and is a graduate of Other (1999).

NPPES Registry Identity

NPI1295761690
Entity TypeIndividualFemale
Primary Taxonomy208M00000X
Provider Legal NamePRATHIBHA POTHARLANKACredential: M.D.
Location Address218 SUNSET RDWillingboro, NJ 08046-1110
Mailing Address30 Belmont CirColumbus, NJ 08022-9714 · (609) 789-0800 · Fax (609) 298-0491
Fax(856) 566-2797
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateJune 25, 2006
Last NPPES UpdateSeptember 6, 2016
NPI 1295761690 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License Licensed in NJ · 25MA07690100
Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedInternal MedicineTaxonomy 207R00000X · License 25MA07690100 (NJ)
218 SUNSET RD, Willingboro, NJ 08046

Other Identifiers 8

Other7221574NJ · Aetna Ppo
Medicare ID-Type Unspecified083658NJ
Medicaid0033120NJ
Medicare PIN083658XPFNJ
Medicaid0078875NJ
OtherP00603546-MERCERNJ · Railroad Medicare
Medicare UPINI17099NJ
Medicare PIN083658ZPCNNJ

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

Prathibha Potharlanka 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 ID4587633862
PECOS Enrollment IDI20041004000017
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 6

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
299 services93 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
156 services14 patients
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.
66 services20 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.
29 services18 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
20 services11 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
14 services12 patients

Hospital Affiliations CMS Care Compare 2

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

University Medical Center Of Princeton At Plainsboro

Acute Care Hospitals · Plainsboro, NJ
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310010
LocationOne-Five Plainsboro RoadPlainsboro, NJ 08536 · Middlesex County
Emergency services Birthing friendly

Virtua Mount Holly Hospital

Acute Care Hospitals · Mount Holly, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310057
Location175 Madison AveMount Holly, NJ 08060 · Burlington County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08046 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
$140.34 typical visit price
range $61.59 – $185.05
Typical copayment $35.08 (range $15.39 – $46.26)
Most-billed visit code 99204
Established Patient
$107.94 typical visit price
range $20.08 – $150.98
Typical copayment $26.98 (range $5.02 – $37.74)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

87.02/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality85.48
Improvement Activities40
Cost66.71

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
7 suppliers29 claims69 services$6.43 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 15

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

Emergency Medicine
218 SUNSET RD
WILLINGBORO, NJ 08046
Registered Nurse (Registered Nurse First Assistant)
218 SUNSET RD
WILLINGBORO, NJ 08046
Community Health Worker
218 SUNSET RD
WILLINGBORO, NJ 08046
Counselor (Mental Health)
218 SUNSET RD
WILLINGBORO, NJ 08046
Physician Assistant
218 SUNSET RD
WILLINGBORO, NJ 08046
Physician Assistant (Medical)
218 SUNSET RD
WILLINGBORO, NJ 08046
Hospitalist
218 SUNSET RD
WILLINGBORO, NJ 08046
Hospitalist
218 SUNSET RD
WILLINGBORO, NJ 08046

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 Prathibha Potharlanka's NPI number?

The NPI number for Prathibha Potharlanka is 1295761690. It was assigned to this individual provider in the NPPES registry on June 25, 2006.

Where is Prathibha Potharlanka located?

Prathibha Potharlanka practices at 218 Sunset Rd, Willingboro, NJ 08046. The listed phone number is (609) 835-2900.

What is Prathibha Potharlanka's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Prathibha Potharlanka enrolled in Medicare?

Yes. Prathibha Potharlanka 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.

Is Prathibha Potharlanka affiliated with any hospitals?

According to CMS data, Prathibha Potharlanka is affiliated with University Medical Center Of Princeton At Plainsboro and Virtua Mount Holly Hospital.

When was this NPI record last updated?

The NPPES record for Prathibha Potharlanka was last updated on September 6, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.