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DR. PRASAD R. GUDAVALLI MD
NPI 1497750046
Specialist in Brooklyn, NY

Active since June 20, 2005PECOS Enrolled
7702 - 16TH AVE, BROOKLYN, NY 11214(718) 645-2929(718) 621-4119 Get Directions Write a Review

NPPES record last updated: November 5, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Prasad R. Gudavalli Md NPPES

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

DR. PRASAD R. GUDAVALLI MD (NPI 1497750046) is an individual specialist in Brooklyn, New York, licensed in New York (128146) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1497750046
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameDR. PRASAD R. GUDAVALLICredential: MD
Location Address7702 - 16TH AVEBrooklyn, NY 11214-1002
Mailing Address7702 - 16th AveBrooklyn, NY 11214-1002 · (718) 645-2929 · Fax (718) 621-4119
Phone(718) 645-2929
Fax(718) 621-4119
Sole ProprietorYes
Enumeration DateJune 20, 2005
Last NPPES UpdateNovember 5, 2012
✔ NPI 1497750046 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NY · 128146
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
7702 - 16TH AVE, Brooklyn, NY 11214
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Other Identifiers 13

Other128146-A21NY · Healthfirst
Other4556190NY · Cigna Healthcare
Medicare UPINC05116NY
Other0C0646NY · Healthnet
Other07A361NY · Blue Cross & Blue Shield
Other97367NY · Aetna Us Healthcare
Medicaid00366349NY
Other069508793NY · United Healthcare
Other1000016766NY · Affinity
OtherOXFORDNY · P393018
Medicare ID-Type Unspecified07A361NY · Medicare Provider #
Other0046803NY · Group Health Inc.
Other069508709NY · Oxford Health Plan

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Prasad R. Gudavalli Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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 Prasad Gudavalli's NPI number?

The NPI number for Prasad Gudavalli is 1497750046. It was assigned to this individual provider in the NPPES registry on June 20, 2005.

Where is Prasad Gudavalli located?

Prasad Gudavalli practices at 7702 - 16th Ave, Brooklyn, NY 11214. The listed phone number is (718) 645-2929.

What is Prasad Gudavalli's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Prasad Gudavalli enrolled in Medicare?

Yes. Prasad Gudavalli is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Prasad Gudavalli was last updated on November 5, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.