DR. SHEELA S PRAHALAD M.D.
NPI 1487687752
Internal Medicine in Clarks Summit, PA

Q: What is Sheela Prahalad's NPI number?

The NPI number for Sheela Prahalad is 1487687752. It was assigned to this individual provider in the NPPES registry on July 9, 2006.

Q: What is Sheela Prahalad's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Sheela Prahalad was last updated on March 2, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 09, 2006PECOS EnrolledAccepts Medicare Assignment

99.15/100

CMS Quality Rating

319 N STATE ST, CLARKS SUMMIT, PA 18411(570) 586-6087(570) 586-6072 Get Directions Write a Review

NPPES record last updated: March 2, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Sheela S Prahalad M.d. NPPES

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

DR. SHEELA S PRAHALAD M.D. (NPI 1487687752) is an individual internal medicine provider in Clarks Summit, Pennsylvania, licensed in Pennsylvania (MD 038374 E) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, is affiliated with Geisinger-community Medical Center, and is a graduate of Other (1981).

NPPES Registry Identity

NPI1487687752

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameDR. SHEELA S PRAHALADCredential: M.D.

Location Address319 N STATE STClarks Summit, PA 18411-1059

Mailing Address319 N State StClarks Summit, PA 18411-1059 · (570) 586-6087 · Fax (570) 586-6072

Phone(570) 586-6087

Fax(570) 586-6072

Sole ProprietorYes

Medical School CMSOtherGraduated 1981

Enumeration DateJuly 9, 2006

Last NPPES UpdateMarch 2, 2009

✔ NPI 1487687752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in PA · MD 038374 E

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

319 N STATE ST, Clarks Summit, PA 18411

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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. Sheela S Prahalad 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 ID2466589254

PECOS Enrollment IDI20100428000041

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 12

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.

Telephone medical discussion with physician, 5-10 minutes 99441

A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.

931 services198 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.

348 services157 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

151 services151 patients

Telephone medical discussion with physician, 11-20 minutes 99442

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

60 services44 patients

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.

54 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.

18 services15 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.

17 services15 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

17 services13 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.

16 services12 patients

Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a G0179

This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.

16 services16 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

12 services12 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

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.

Geisinger-Community Medical Center

Acute Care Hospitals · Scranton, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390001

Location1822 Mulberry StreetScranton, PA 18510 · Lackawanna County

Emergency services Birthing friendly

Wilkes-Barre General Hospital

Acute Care Hospitals · Wilkes-Barre, PA

1/5 CMS rating

OwnershipProprietary

CMS Certification Number390137

Location575 North River StreetWilkes-Barre, PA 18764 · Luzerne County

Emergency services

Regional Hospital Of Scranton

Acute Care Hospitals · Scranton, PA

2/5 CMS rating

OwnershipProprietary

CMS Certification Number390237

Location746 Jefferson AvenueScranton, PA 18501 · Lackawanna County

Emergency services Birthing friendly

Geisinger Wyoming Valley Medical Center

Acute Care Hospitals · Wilkes Barre, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390270

Location1000 East Mountain BoulevardWilkes Barre, PA 18711 · Luzerne County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18411 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

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

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.

99.15/100

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

Individually scored

Promoting Interoperability

Improvement Activities

Reported Quality Measures

Provide Patients Electronic Access to Their Health Information

99%365 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 21

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 suppliers24 claims88 services$5.37 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

3 suppliers17 claims17 services$66.56 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

3 suppliers19 claims48 services$24.53 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

3 suppliers12 claims12 services$35.37 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

3 suppliers17 claims17 services$13.71 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

4 suppliers20 claims20 services$8.49 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

5 suppliers36 claims158 services$1.42 avg. paid by Medicare

Filter, non disposable, used with positive airway pressure device A7039

DME-Other DME · category DE001N

3 suppliers12 claims12 services$5.08 avg. paid by Medicare

Enteral nutrition infusion pump, any type B9002

Other-Enteral and Parenteral · category OB005N

1 supplier12 claims12 services$50.80 avg. paid by Medicare

Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty E0181

DME-Other DME · category DE000N

1 supplier12 claims12 services$10.93 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

1 supplier20 claims20 services$44.47 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers19 claims19 services$7.20 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

3 suppliers48 claims48 services$3.17 avg. paid by Medicare

Respiratory suction pump, home model, portable or stationary, electric E0600

DME-Other DME · category DE000N

1 supplier12 claims12 services$36.00 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

3 suppliers28 claims29 services$26.33 avg. paid by Medicare

Iv pole E0776

DME-Other DME · category DE000N

1 supplier12 claims12 services$8.17 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

6 suppliers529 claims529 services$53.87 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

2 suppliers19 claims19 services$32.59 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

8 suppliers48 claims5,412 services$0.09 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

5 suppliers17 claims1,020 services$0.72 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

7 suppliers48 claims48 services$24.64 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES

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

SHEELA PRAHALAD M.D. PC

Internal Medicine

319 N STATE ST
CLARKS SUMMIT, PA 18411

Lackawanna County (570) 586-6087

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 Sheela Prahalad's NPI number?

The NPI number for Sheela Prahalad is 1487687752. It was assigned to this individual provider in the NPPES registry on July 9, 2006.

Where is Sheela Prahalad located?

Sheela Prahalad practices at 319 N State St, Clarks Summit, PA 18411. The listed phone number is (570) 586-6087.

What is Sheela Prahalad's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Sheela Prahalad enrolled in Medicare?

Yes. Sheela Prahalad 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 Sheela Prahalad affiliated with any hospitals?

According to CMS data, Sheela Prahalad is affiliated with Geisinger-Community Medical Center, Wilkes-Barre General Hospital, Regional Hospital Of Scranton and Geisinger Wyoming Valley Medical Center.

When was this NPI record last updated?

The NPPES record for Sheela Prahalad was last updated on March 2, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.