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DR. PHALGUN PRATIVADI M.D.
NPI 1598920985
Internal Medicine - Infectious Disease in Monroeville, PA

Active since July 24, 2008PECOS EnrolledAccepts Medicare Assignment
93.78/100
CMS Quality Rating
3824 NORTHERN PIKE STE 405, MONROEVILLE, PA 15146(412) 372-8750(412) 372-8751 Get Directions Write a Review

NPPES record last updated: November 4, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 4, 2020, Nov 18, 2019, Feb 1, 2017 (3 updates tracked since 2017).

About Dr. Phalgun Prativadi M.d. NPPES

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

DR. PHALGUN PRATIVADI M.D. (NPI 1598920985) is an individual infectious disease provider in Monroeville, Pennsylvania, licensed in Pennsylvania (MD448148) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS, is affiliated with Allegheny Valley Hospital, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1598920985
Entity TypeIndividualMale
Primary Taxonomy207RI0200X
Provider Legal NameDR. PHALGUN PRATIVADICredential: M.D.
Location Address3824 NORTHERN PIKE STE 405Monroeville, PA 15146-2121
Mailing Address3824 Northern Pike, Ste 700Monroeville, PA 15146-2141 · (412) 457-0060
Phone(412) 372-8750
Fax(412) 372-8751
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateJuly 24, 2008
Last NPPES UpdateNovember 4, 20203 updates tracked since enumeration
NPPES CertifiedNovember 4, 2020
✔ NPI 1598920985 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
License✔ Licensed in PA · MD448148
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
3824 NORTHERN PIKE STE 405, Monroeville, PA 15146
Open in Google Maps ↗

Other Identifiers 2

Other2897144PA · Highmark
Medicaid1028222820001PA

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

Dr. Phalgun Prativadi M.d. 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 ID5890938864
PECOS Enrollment IDI20130823000968
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 4

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.

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.
327 services112 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.
181 services162 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.
149 services71 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.
13 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Allegheny Valley Hospital

Acute Care Hospitals · Natrona, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390032
Location1301 Carlisle StNatrona, PA 15065 · Allegheny County
Emergency services

Forbes Hospital

Acute Care Hospitals · Monroeville, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390267
Location2570 Haymaker RoadMonroeville, PA 15146 · Allegheny County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15146 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

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.

93.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.07
Promoting Interoperability100
Improvement Activities40

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.

MS. ALEXIS ANN SCOTT MSN, FNP-C, CRNP
Nurse Practitioner (Family)
3824 NORTHERN PIKE STE 405
MONROEVILLE, PA 15146
Allegheny County (412) 457-0424
RETINA ASSOCIATES OF PENNSYLVANIA, PC
Ophthalmology (Retina Specialist)
3824 NORTHERN PIKE STE 405
MONROEVILLE, PA 15146
Allegheny County (412) 307-1740

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 Phalgun Prativadi's NPI number?

The NPI number for Phalgun Prativadi is 1598920985. It was assigned to this individual provider in the NPPES registry on July 24, 2008.

Where is Phalgun Prativadi located?

Phalgun Prativadi practices at 3824 Northern Pike Ste 405, Monroeville, PA 15146. The listed phone number is (412) 372-8750.

What is Phalgun Prativadi's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Phalgun Prativadi enrolled in Medicare?

Yes. Phalgun Prativadi 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 Phalgun Prativadi affiliated with any hospitals?

According to CMS data, Phalgun Prativadi is affiliated with Allegheny Valley Hospital and Forbes Hospital.

When was this NPI record last updated?

The NPPES record for Phalgun Prativadi was last updated on November 4, 2020. 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.