DR. PRASHANTH NMI VALLABHANATH MD
NPI 1386626372
Ophthalmology - Ophthalmic Plastic and Reconstructive Surgery in Portland, OR

Active since November 16, 2005PECOS EnrolledAccepts Medicare Assignment
92.68/100
CMS Quality Rating
1955 NW NORTHRUP ST, PORTLAND, OR 97209(503) 227-2020(503) 222-0614 Get Directions Write a Review

NPPES record last updated: February 20, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Prashanth Nmi Vallabhanath Md NPPES

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

DR. PRASHANTH NMI VALLABHANATH MD (NPI 1386626372) is an individual ophthalmic plastic and reconstructive surgery provider in Portland, Oregon, licensed in Oregon (MD22584) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS and is a graduate of University Of Michigan Medical School (1994).

NPPES Registry Identity

NPI1386626372
Entity TypeIndividualMale
Primary Taxonomy207WX0200X
Provider Legal NameDR. PRASHANTH NMI VALLABHANATHCredential: MD
Location Address1955 NW NORTHRUP STPortland, OR 97209-1614
Mailing AddressPo Box 22009Portland, OR 97269-2009 · (503) 558-7372 · Fax (503) 344-5140
Fax(503) 222-0614
Sole ProprietorNo
Medical School CMSUniversity Of Michigan Medical SchoolGraduated 1994
Enumeration DateNovember 16, 2005
Last NPPES UpdateFebruary 20, 2021
NPPES CertifiedFebruary 20, 2021
NPI 1386626372 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOphthalmology · Ophthalmic Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207WX0200X
License Licensed in OR · MD22584
Definition

A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck.

Also ListedOphthalmologyTaxonomy 207W00000X · License MD22584 (OR)
1955 NW NORTHRUP ST, Portland, OR 97209

Other Identifiers 1

Medicaid288426OR

Accepted 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

Dr. Prashanth Nmi Vallabhanath Md 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 ID2163502667
PECOS Enrollment IDI20100211000549
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 19

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.

Injection, onabotulinumtoxina, 1 unit J0585
Onabotulinumtoxina, also known as Botox, is a medication injected into muscles. It's used to treat various conditions by blocking nerve activity in the muscles, causing a temporary reduction in muscle activity. The units refer to the dosage.
846 services11 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
380 services370 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.
343 services322 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.
200 services165 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
181 services172 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
140 services132 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97209 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
$134.16 typical visit price
range $58.99 – $176.88
Typical copayment $33.54 (range $14.74 – $44.22)
Most-billed visit code 99204
Established Patient
$73.28 typical visit price
range $19.32 – $144.79
Typical copayment $18.32 (range $4.83 – $36.19)
Most-billed visit code 99213
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.

92.68/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality99.19
Promoting Interoperability100
Improvement Activities40
Cost76.42

Other Providers at the Same Location NPPES 18

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

Ophthalmology
1955 NW NORTHRUP ST
PORTLAND, OR 97209
Ophthalmology
1955 NW NORTHRUP ST
PORTLAND, OR 97209
Eyewear Supplier
1955 NW NORTHRUP ST
PORTLAND, OR 97209
Ophthalmology
1955 NW NORTHRUP ST
PORTLAND, OR 97209
Ophthalmology
1955 NW NORTHRUP ST
PORTLAND, OR 97209
Ophthalmology
1955 NW NORTHRUP ST
PORTLAND, OR 97209
Ophthalmology
1955 NW NORTHRUP ST
PORTLAND, OR 97209
Ophthalmology
1955 NW NORTHRUP ST
PORTLAND, OR 97209

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 Prashanth Vallabhanath's NPI number?

The NPI number for Prashanth Vallabhanath is 1386626372. It was assigned to this individual provider in the NPPES registry on November 16, 2005.

Where is Prashanth Vallabhanath located?

Prashanth Vallabhanath practices at 1955 NW Northrup St, Portland, OR 97209. The listed phone number is (503) 227-2020.

What is Prashanth Vallabhanath's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Ophthalmic Plastic and Reconstructive Surgery, with taxonomy code 207WX0200X.

Is Prashanth Vallabhanath enrolled in Medicare?

Yes. Prashanth Vallabhanath 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.

What insurance does Prashanth Vallabhanath accept?

Health plans from BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc., PacificSource Health Plans and Providence Health Plan and 1 other insurer list Prashanth Vallabhanath as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Prashanth Vallabhanath was last updated on February 20, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.