SUSHMA PRATHIPATI MBBS, MD
NPI 1598115446
Family Medicine in Schenectady, NY

Active since June 21, 2016PECOS EnrolledAccepts Medicare Assignment
1201 NOTT ST STE 204, SCHENECTADY, NY 12308(518) 243-3388 Get Directions Write a Review

NPPES record last updated: December 16, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 16, 2021, Feb 14, 2020, Jun 21, 2016 (3 updates tracked since 2016).

About Sushma Prathipati Mbbs, Md NPPES

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

SUSHMA PRATHIPATI MBBS, MD (NPI 1598115446) is an individual family medicine provider in Schenectady, New York, licensed in New York (301404) and active in the NPI registry since June 2016. She is enrolled in Medicare PECOS, is affiliated with Ellis Hospital, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1598115446
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameSUSHMA PRATHIPATICredential: MBBS, MD
Location Address1201 NOTT ST STE 204Schenectady, NY 12308-2589
Mailing Address1201 Nott St Ste 204Schenectady, NY 12308-2589 · (518) 243-3388
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateJune 21, 2016
Last NPPES UpdateDecember 16, 20213 updates tracked since enumeration
NPPES CertifiedDecember 16, 2021
NPI 1598115446 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in NY · 301404
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.
1201 NOTT ST STE 204, Schenectady, NY 12308

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

Sushma Prathipati Mbbs, 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 ID446683445
PECOS Enrollment IDI20191205001025
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 2

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.

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.
102 services57 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.
36 services36 patients

Hospital Affiliations CMS Care Compare

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

Ellis Hospital

Acute Care Hospitals · Schenectady, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330153
Location1101 Nott StreetSchenectady, NY 12308 · Schenectady County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12308 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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 2

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
8 suppliers21 claims51 services$6.33 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
9 suppliers18 claims27 services$1.17 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

Clinic/Center (Primary Care)
1201 NOTT ST STE 204
SCHENECTADY, NY 12308
Nurse Practitioner (Family)
1201 NOTT ST STE 204
SCHENECTADY, NY 12308

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 Sushma Prathipati's NPI number?

The NPI number for Sushma Prathipati is 1598115446. It was assigned to this individual provider in the NPPES registry on June 21, 2016.

Where is Sushma Prathipati located?

Sushma Prathipati practices at 1201 Nott St Ste 204, Schenectady, NY 12308. The listed phone number is (518) 243-3388.

What is Sushma Prathipati's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sushma Prathipati enrolled in Medicare?

Yes. Sushma Prathipati 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 Sushma Prathipati affiliated with any hospitals?

According to CMS data, Sushma Prathipati is affiliated with Ellis Hospital.

When was this NPI record last updated?

The NPPES record for Sushma Prathipati was last updated on December 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.