PRABHAKAR MITHAL
NPI 1497172951
Urology in Fayetteville, GA

Q: What is Prabhakar Mithal's NPI number?

The NPI number for Prabhakar Mithal is 1497172951. It was assigned to this individual provider in the NPPES registry on March 23, 2014.

Q: What is Prabhakar Mithal's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Prabhakar Mithal was last updated on June 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 23, 2014PECOS EnrolledAccepts Medicare Assignment

61.48/100

CMS Quality Rating

1336 HIGHWAY 54 W BLDG 200, FAYETTEVILLE, GA 30214(770) 460-9777 Get Directions Write a Review

NPPES record last updated: June 15, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 15, 2021, Oct 26, 2020 (2 updates tracked since 2020).

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About Prabhakar Mithal NPPES

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

PRABHAKAR MITHAL (NPI 1497172951) is an individual urology provider in Fayetteville, Georgia, licensed in Georgia (89259) and active in the NPI registry since March 2014. He is enrolled in Medicare PECOS, is affiliated with Piedmont Hospital, and is a graduate of University Of Massachusetts Medical School (2014).

NPPES Registry Identity

NPI1497172951

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NamePRABHAKAR MITHAL

Location Address1336 HIGHWAY 54 W BLDG 200Fayetteville, GA 30214-4574

Mailing Address1930 Brannan RdMcdonough, GA 30253-4310 · (678) 284-4040

Phone(770) 460-9777

Sole ProprietorNo

Medical School CMSUniversity Of Massachusetts Medical SchoolGraduated 2014

Enumeration DateMarch 23, 2014

Last NPPES UpdateJune 15, 20212 updates tracked since enumeration

NPPES CertifiedApril 29, 2021

✔ NPI 1497172951 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in GA · 89259

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

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

1336 HIGHWAY 54 W BLDG 200, Fayetteville, GA 30214

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.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

Prabhakar Mithal 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 ID1456695550

PECOS Enrollment IDI20210623001879

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 20

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.

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

382 services269 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.

253 services201 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.

180 services149 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.

118 services118 patients

Psa (prostate specific antigen) measurement, total 84153

PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.

88 services73 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

68 services59 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

55 services49 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

27 services21 patients

Simple bladder irrigation and/or instillation 51700

Bladder irrigation and/or instillation is a process where a sterile solution is introduced into the bladder to cleanse it or deliver medication. This procedure helps manage certain bladder conditions, ensuring optimal bladder health.

27 services21 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

25 services25 patients

Complex measurement of pressure of urine flow in bladder with voiding pressure studies 51728

This procedure measures the pressure in your bladder as it fills and empties. It helps to understand how well your bladder is functioning. Sensors record pressure levels during these processes, providing valuable data for your doctor.

23 services23 patients

Testosterone (hormone) level, total 84403

A total testosterone level test measures the amount of a key hormone in your body. This hormone influences various body functions such as muscle mass, energy levels, and mood. The test involves a simple blood draw, and results help monitor health conditions.

22 services18 patients

Simple insertion of temporary bladder tube 51702

This procedure involves placing a temporary tube into your bladder to help with urine flow. It's done when the body can't naturally remove urine. The tube is inserted through a small opening and allows urine to drain into a bag. It's usually a short-term solution.

20 services15 patients

Electronic assessment of bladder emptying 51741

Electronic assessment of bladder emptying is a non-invasive test that measures how well your bladder functions. It uses ultrasound technology to create images of your bladder before and after you use the restroom, helping to identify any issues with bladder emptying.

19 services19 patients

Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings 51784

This procedure involves the use of non-invasive devices to record the electrical activity of muscles at specific body openings. It's helpful in understanding muscle function and can assist in diagnosing certain conditions.

19 services19 patients

Insertion of device into abdomen with pressure and urine flow rate study 51797

This procedure involves placing a small device into your abdomen to monitor pressure and urine flow rates. It helps in understanding how well your body is processing and eliminating liquid waste. It's a safe procedure, typically performed under local anesthesia.

19 services19 patients

Ultrasound scan of pelvic region through rectum 76872

An ultrasound scan of the pelvic region through the rectum is a medical procedure where a small, smooth device is gently inserted into the rectum. This device uses sound waves to create images of the internal structures in the lower abdomen, aiding in diagnosis and treatment planning.

16 services16 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

16 services16 patients

Imaging of urinary tract following injection of a contrast agent 74420

This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.

15 services13 patients

Psa (prostate specific antigen) measurement, free 84154

A PSA measurement, free, is a simple blood test that checks for a specific protein produced by your body. Higher levels may indicate a health concern that needs further investigation. This test is often used to monitor overall wellness.

14 services13 patients

Hospital Affiliations CMS Care Compare 5

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

Piedmont Hospital

Acute Care Hospitals · Atlanta, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110083

Location1968 Peachtree Rd NWAtlanta, GA 30309 · Fulton County

Emergency services Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110161

Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County

Birthing friendly

Piedmont Henry Hospital

Acute Care Hospitals · Stockbridge, GA

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110191

Location1133 Eagle's Landing ParkwayStockbridge, GA 30281 · Henry County

Emergency services Birthing friendly

Piedmont Fayette Hospital

Acute Care Hospitals · Fayetteville, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110215

Location1255 Highway 54 WestFayetteville, GA 30214 · Fayette County

Emergency services Birthing friendly

Piedmont Newnan Hospital, Inc

Acute Care Hospitals · Newnan, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110229

Location745 Poplar RoadNewnan, GA 30265 · Coweta County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30214 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

$130.64 typical visit price

range $56.84 – $172.43

Typical copayment $32.66 (range $14.21 – $43.10)

Most-billed visit code 99204

Established Patient

$70.85 typical visit price

range $18.22 – $140.40

Typical copayment $17.71 (range $4.55 – $35.10)

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.

61.48/100

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

Individually scored

Quality

43.24

Promoting Interoperability

Improvement Activities

Cost

30.87

Reported Quality Measures

Controlling High Blood Pressure

28%314 patients2/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

58%3,238 patients1/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

75%1,902 patients3/55-star benchmark: 100%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 59% · 732 patients

Patients screened: 95% · 732 patients

2%282 patients1/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

96%713 patients4/55-star benchmark: 100%

Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older

99%254 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.

Other Providers at the Same Location NPPES 6

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

BRITTANI LINNEA BARRETT-HARLOW M.D.

Urology