PRAGNESHKUMAR N RADADIYA MD
NPI 1548421985
Family Medicine in Indianapolis, IN

Q: What is the provider's specialty?

The provider's specialty is Family Medicine with taxonomy code 207Q00000X.

Active since June 18, 2008PECOS EnrolledAccepts Medicare Assignment

1402 E COUNTY LINE RD, INDIANAPOLIS, IN 46227(317) 887-7805 Get Directions Write a Review

NPPES record last updated: May 11, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 11, 2017, Dec 29, 2016 (2 updates tracked since 2016).

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About Pragneshkumar N Radadiya Md NPPES

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

PRAGNESHKUMAR N RADADIYA MD (NPI 1548421985) is an individual family medicine provider in Indianapolis, Indiana, licensed in Indiana (01069393A) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS, is affiliated with Reid Health, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1548421985

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NamePRAGNESHKUMAR N RADADIYACredential: MD

Location Address1402 E COUNTY LINE RDIndianapolis, IN 46227-0963

Mailing Address6626 E 75th St, Ste 500Indianapolis, IN 46250-2805

Phone(317) 887-7805

Sole ProprietorNo

Medical School CMSOtherGraduated 2004

Enumeration DateJune 18, 2008

Last NPPES UpdateMay 11, 20172 updates tracked since enumeration

✔ NPI 1548421985 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in IN · 01069393A

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1402 E COUNTY LINE RD, Indianapolis, IN 46227

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Other Identifiers 3

Medicaid201022010IN

Medicare PINP01815024IN

Medicare PININ2318005IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, 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

Pragneshkumar N Radadiya 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 ID4880886621

PECOS Enrollment IDI20110620000655

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 14

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

1,020 services487 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

782 services626 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

615 services371 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.

392 services206 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.

364 services173 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

348 services219 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

245 services209 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

243 services231 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.

61 services61 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

44 services44 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

23 services23 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

23 services15 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

21 services20 patients

Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348

An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.

18 services18 patients

Hospital Affiliations CMS Care Compare 5

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

Reid Health

Acute Care Hospitals · Richmond, IN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150048

Location1100 Reid PkwyRichmond, IN 47374 · Wayne County

Emergency services Birthing friendly

Indiana University Health

Acute Care Hospitals · Indianapolis, IN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150056

Location1701 N Senate BlvdIndianapolis, IN 46202 · Marion County

Emergency services Birthing friendly

Community Hospital South, Inc.

Acute Care Hospitals · Indianapolis, IN

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150128

Location1402 E County Line Rd SIndianapolis, IN 46227 · Marion County

Emergency services Birthing friendly

Franciscan Health Rensselaer, Inc

Critical Access Hospitals · Rensselaer, IN

OwnershipVoluntary non-profit - Private

CMS Certification Number151324

Location1104 E Grace StRensselaer, IN 47978 · Jasper County

Emergency services

St Elizabeth Edgewood

Acute Care Hospitals · Edgewood, KY

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number180035

Location1 Medical Village DriveEdgewood, KY 41017 · Kenton County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46227 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

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

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.

Referred Medical Equipment & Supplies CMS DME claims 33

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) A4314

DME-Orthotic Devices · category DF000N

5 suppliers86 claims86 services$24.37 avg. paid by Medicare

Urinary catheter anchoring device, adhesive skin attachment, each A4333

DME-Orthotic Devices · category DF000N

2 suppliers32 claims384 services$2.08 avg. paid by Medicare

Urinary catheter anchoring device, leg strap, each A4334

DME-Orthotic Devices · category DF000N

2 suppliers24 claims24 services$4.73 avg. paid by Medicare

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

5 suppliers118 claims149 services$9.22 avg. paid by Medicare

Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each A4358

DME-Orthotic Devices · category DF000N

2 suppliers19 claims38 services$5.45 avg. paid by Medicare

Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each A4409

DME-Orthotic Devices · category DF010N

2 suppliers22 claims440 services$6.01 avg. paid by Medicare

Tape, non-waterproof, per 18 square inches A4450

DME-Medical/Surgical Supplies · category DA000N

1 supplier36 claims2,148 services$0.10 avg. paid by Medicare

Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each A5063

DME-Orthotic Devices · category DF010N

2 suppliers17 claims300 services$2.61 avg. paid by Medicare

For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe A5500

DME-Orthotic Devices · category DF000N

5 suppliers31 claims62 services$61.10 avg. paid by Medicare

For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each A5512

DME-Orthotic Devices · category DF000N

4 suppliers30 claims180 services$24.91 avg. paid by Medicare

Collagen based wound filler, dry form, sterile, per gram of collagen A6010