DR. SAI PRASHANTH BABU PALEPU MD
NPI 1558673152
Family Medicine in St. Louis, MO
NPI Status: Active since July 12, 2010
Contact Information
10018 KENNERLY RD.
ST. LOUIS, MO
ZIP 63128
Phone: (314) 208-6000
- Individual
- Male
- Years of Experience 19
- Family Medicine
- Accepts Insurance
- May Accept Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About SAI PRASHANTH PALEPU
This page provides the complete NPI Profile along with additional information for Sai Prashanth Palepu, a primary care provider established in St. Louis, Missouri with a medical specialization in Family Medicine and more than 19 years of experience. The healthcare provider is registered in the NPI registry with number 1558673152 assigned on July 2010. The practitioner's primary taxonomy code is 207Q00000X with license number 2017011098 (MO). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1558673152
- Provider Name
- DR. SAI PRASHANTH BABU PALEPU MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 10018 KENNERLY RD. ST. LOUIS, MO 63128
- Location Phone
- (314) 208-6000
- Mailing Address
- 21 EASTBROOK BEND SUITE 18 PEACHTREE CITY, GA 30269
- Mailing Phone
- (678) 967-5599
- Mailing Fax
- Medical School Name
- OTHER
- Graduation Year
- 2007
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-12-2010
- Last Update Date
- 05-23-2023
- Code Navigator
A primary care provider (PCP) like Sai Prashanth Palepu sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
Secondary Locations
- 4500 Memorial Dr
Belleville, IL 62226
(618) 257-6220
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 2017011098
- License State
- MO
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | BP1-0037472 (TX) |
| 2 | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | 2017011098 (MO) |
| 3 | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | 036132314 (IL) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- BlueCare EPO Bronze - EPO
- BlueCare EPO Gold - EPO
- BlueCare EPO Gold Plus - EPO
- BlueCare EPO Silver Plus - EPO
- BlueCare EPO Simple Bronze HDHP - EPO
- BlueCare EPO Simple Silver HDHP - EPO
- BlueCare EPO Standardized Expanded Bronze - EPO
- BlueCare EPO Standardized Gold - EPO
- BlueCare EPO Standardized Silver - EPO
- Partners HMO Bronze 10600 Ded/10600 MOOP HSA - HMO
- Partners HMO Bronze 6000 Ded/10600 MOOP HSA - HMO
- Partners HMO Bronze 7500 Ded/10000 MOOP HSA - HMO
- Partners HMO Gold 1500 Ded/8000 MOOP with Vision - HMO
- Partners HMO Gold 2000 Ded/8200 MOOP - HMO
- Partners HMO Gold 4000 Ded/4000 MOOP HSA - HMO
- Partners HMO Silver 5500 Ded/8500 MOOP with Vision - HMO
- Partners HMO Silver 5975 Ded/5975 MOOP HSA - HMO
- Partners HMO Silver 6000 Ded/8900 MOOP - HMO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Bronze Simple Diabetes - EPO
- Gold Classic Standard - EPO
- Gold Simple - EPO
- Silver Classic Standard - EPO
- Silver Elite Saver Plus - EPO
- Silver Simple Diabetes - EPO
- Silver Simple PCP Saver - EPO
- Silver Simple Women's Health with Menopause Benefits - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Sai Prashanth Palepu is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
Sai Prashanth Palepu is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 3072757616
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20130920000142, I20171121002915, I20191212000345
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Maybe
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Hospital discharge day management, more than 30 minutes
Initial hospital inpatient care per day, typically 70 minutes
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.
This service was performed 1,845 times for 276 patientsFollow-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.
This service was performed 182 times for 65 patientsHospital 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.
This service was performed 67 times for 64 patientsInitial 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.
This service was performed 150 times for 137 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 63128 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $86.32
- Minimum New Patient Price $55.65
- Maximum New Patient Price $169.38
- Average New Patient Copayment $21.58
- Minimum New Patient Copayment $13.91
- Maximum New Patient Copayment $42.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $98.37
- Minimum Established Patient Price $17.76
- Maximum Established Patient Price $137.92
- Average Established Patient Copayment $24.59
- Minimum Established Patient Copayment $4.44
- Maximum Established Patient Copayment $34.48
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Care Plan | 99% | 122 |
| Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan | ||
| Consultation of the Prescription Drug Monitoring Program | Yes | N/A |
| Clinicians would attest to reviewing the patients’ history of controlled substance prescription using state prescription drug monitoring program (PDMP) data prior to the issuance of a Controlled Substance Schedule II (CSII) opioid prescription lasting longer than 3 days. For the transition year, clinicians would attest to 60 percent review of applicable patient’s history. For the Quality Payment Program Year 2 and future years, clinicians would attest to 75 percent review of applicable patient’s history performance. | ||
| Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms. | Yes | N/A |
| Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Sai Prashanth Palepu is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| MEMORIAL HOSPITAL OF LAFAYETTE COUNTY | 800 CLAY ST DARLINGTON, WI 53530 | (608) 776-4466 | Critical Access Hospitals | |
| EDGERTON HOSPITAL AND HEALTH SERVICES | 11101 N SHERMAN ROAD EDGERTON, WI 53534 | (608) 884-3441 | Critical Access Hospitals | |
| UPLAND HILLS HEALTH | 800 COMPASSION WAY DODGEVILLE, WI 53533 | (608) 930-8000 | Critical Access Hospitals |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1558673152, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 58 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1558673152, enumerated as an "individual" on July 12, 2010.
The provider is located at 10018 KENNERLY RD. ST. LOUIS, MO 63128 and the phone number is (314) 208-6000.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Blue Cross and. Please consult your insurance carrier or call the provider to verify.
Sai Prashanth Palepu is affiliated with: MEMORIAL HOSPITAL OF LAFAYETTE COUNTY, EDGERTON HOSPITAL AND HEALTH SERVICES and UPLAND HILLS HEALTH.
