PRASHANTH RAU M.D.
NPI 1336501311
Internal Medicine - Gastroenterology in Worcester, MA

Q: What is Prashanth Rau's NPI number?

The NPI number for Prashanth Rau is 1336501311. It was assigned to this individual provider in the NPPES registry on March 28, 2016.

Q: What is Prashanth Rau's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Prashanth Rau was last updated on June 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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 March 28, 2016PECOS EnrolledAccepts Medicare Assignment

97.02/100

CMS Quality Rating

119 BELMONT ST, WORCESTER, MA 01605(508) 334-2846(508) 856-3981 Get Directions Write a Review

NPPES record last updated: June 6, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 6, 2022, Jun 13, 2016, Mar 28, 2016 (3 updates tracked since 2016).

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About Prashanth Rau M.d. NPPES

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

PRASHANTH RAU M.D. (NPI 1336501311) is an individual gastroenterology provider in Worcester, Massachusetts, licensed in Massachusetts (292150) and active in the NPI registry since March 2016. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Healthalliance Hospitals, and is a graduate of University Of Massachusetts Medical School (2016).

NPPES Registry Identity

NPI1336501311

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NamePRASHANTH RAUCredential: M.D.

Location Address119 BELMONT STWorcester, MA 01605-2903

Mailing AddressPo Box 415348Boston, MA 02241-5348 · (800) 225-8885 · Fax (508) 334-1977

Phone(508) 334-2846

Fax(508) 856-3981

Sole ProprietorNo

Medical School CMSUniversity Of Massachusetts Medical SchoolGraduated 2016

Enumeration DateMarch 28, 2016

Last NPPES UpdateJune 6, 20223 updates tracked since enumeration

NPPES CertifiedJune 6, 2022

✔ NPI 1336501311 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in MA · 292150

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

119 BELMONT ST, Worcester, MA 01605

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Other Identifiers 1

Medicaid110115231AMA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Prashanth Rau 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 ID2163716044

PECOS Enrollment IDI20220621001332

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 16

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.

Review by radiologist of image from tube placement into bile duct using an endoscope 74328

This procedure involves a specialist, called a radiologist, examining an image taken during a tube placement into your bile duct. The tube is inserted with the help of a tool called an endoscope. This allows the doctor to check for any issues or abnormalities in your bile duct.

72 services49 patients

Removal of stone or debris from bile or pancreatic duct using a flexible endoscope 43264

This procedure, called an endoscopic retrograde cholangiopancreatography (ERCP), involves using a flexible tube with a camera (endoscope) to locate and remove stones or debris from your bile or pancreatic duct. It's a non-surgical method to clear the ducts, enhancing your digestive health.

62 services45 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

52 services48 patients

Insertion of stent into pancreatic or bile duct using a flexible endoscope 43274

This procedure involves the placement of a tiny tube, known as a stent, into your pancreatic or bile duct. A flexible endoscope, a long, thin instrument with a light and camera, is used. It aids in relieving blockages and improving flow in these ducts.

49 services38 patients

Review by radiologist of bile and/or pancreatic duct image during surgery 74300

This is a procedure where a radiologist examines images of your bile or pancreatic duct during surgery. It helps the surgeon navigate and make precise moves. The images provide real-time insight, ensuring the best possible outcome for your health.

46 services35 patients

Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito G0500

Moderate sedation is a method where a physician uses medication to help you relax during a gastrointestinal endoscopy. An independent trained observer will be present to monitor your vital signs and ensure your safety throughout the procedure. It's a common and safe practice.

37 services34 patients

Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope through mouth 43237

This procedure involves a flexible tube with a camera and ultrasound device, inserted through the mouth to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like inflammation, tumors, or other abnormalities.

36 services35 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

33 services33 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

29 services28 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.

23 services22 patients

Removal of stent from pancreatic or bile duct using a flexible endoscope 43275

This procedure involves removing a stent from your pancreatic or bile duct. A flexible endoscope, a thin tube with a light and camera, is used to locate the stent. Once found, it's carefully extracted. This helps maintain proper duct function.

20 services20 patients

Ultrasound guided needle aspiration or biopsy of esophagus using a flexible endoscope 43238

An ultrasound guided needle aspiration or biopsy of the esophagus involves using a flexible tube with a camera (endoscope) to view your esophagus. An ultrasound device on the endoscope helps to guide a needle to take a small tissue sample for testing. This is a safe, minimally invasive procedure.

18 services16 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

13 services13 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

13 services12 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

13 services13 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

12 services12 patients

Hospital Affiliations CMS Care Compare 4

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

Umass Memorial Healthalliance Hospitals

Acute Care Hospitals · Leominster, MA

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number220001

Location60 Hospital RoadLeominster, MA 01453 · Worcester County

Emergency services

Umass Memorial Health - Harrington Hospital

Acute Care Hospitals · Southbridge, MA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220019

Location100 South StreetSouthbridge, MA 01550 · Worcester County

Emergency services

Milford Regional Medical Center

Acute Care Hospitals · Milford, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number220090

Location14 Prospect StreetMilford, MA 01757 · Worcester County

Emergency services Birthing friendly

Umass Memorial Medical Center/University Campus

Acute Care Hospitals · Worcester, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220163

Location55 Lake Avenue NorthWorcester, MA 01655 · Worcester County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01605 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

$134.47 typical visit price

range $58.86 – $177.36

Typical copayment $33.61 (range $14.71 – $44.34)

Most-billed visit code 99204

Established Patient

$103.48 typical visit price

range $19.11 – $144.84

Typical copayment $25.87 (range $4.77 – $36.21)

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.

97.02/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

78.09

Promoting Interoperability

100

Improvement Activities

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.

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