PRASANNA RAMAN MD
NPI 1609836709
Pediatrics in Stoughton, WI

NPI Status: Active since March 24, 2006

Contact Information

1001 NYGAARD ST
STOUGHTON, WI
ZIP 53589
Phone: (608) 877-2660
Fax: (608) 877-2667

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  • Individual
  • Female
  • Pediatrics
  • Accepts Insurance
  • PECOS Enrolled

About PRASANNA RAMAN

This page provides the complete NPI Profile along with additional information for Prasanna Raman, a pediatrician established in Stoughton, Wisconsin with a medical specialization in Pediatrics. The healthcare provider is registered in the NPI registry with number 1609836709 assigned on March 2006. The practitioner's primary taxonomy code is 208000000X with license number 43662 (WI). The provider is registered as an individual and her NPI record was last updated 5 years ago.

NPI
1609836709
Provider Name
PRASANNA RAMAN MD
Gender
Female
Entity Type
Individual
Location Address
1001 NYGAARD ST STOUGHTON, WI 53589
Location Phone
(608) 877-2660
Location Fax
(608) 877-2667
Mailing Address
7974 UW HEALTH CT MIDDLETON, WI 53562
Is Sole Proprietor?
No
Enumeration Date
03-24-2006
Last Update Date
01-05-2021
Code Navigator

A pediatrician like Prasanna Raman is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Location Map

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

Pediatrics

Taxonomy Code
208000000X
Type
Allopathic & Osteopathic Physicians
License No.
43662
License State
WI
Taxonomy Description
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
  • Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • 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 Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • 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 Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
  • Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
  • Anthem Silver Pathway/Lean 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • 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
  • 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
  • Oak $1,300 Gold - PPO
  • Oak $2,000 Standard Gold - PPO
  • Enrich $2,000 - 25% - HMO
  • Enrich $3,500 - 30% - HMO
  • Enrich $4,000 - 50% - HMO
  • Enrich $5,000 HDHP - HMO
  • Enrich $6,000 - 40% - HMO
  • Enrich $7,500 - HMO
  • Enrich $7,500 HDHP - HMO
  • Enrich $9,500 - HMO
  • Enrich Protection - HMO
  • Premier $2,000 - 25% - HMO
  • Premier $3,500 - 30% - HMO
  • Premier $4,000 - 50% - HMO
  • Premier $5,000 HDHP - HMO
  • Premier $6,000 - 40% - HMO
  • Premier $7,500 - HMO
  • Premier $7,500 HDHP - HMO
  • Enrich $1,500 - 30% - HMO
  • Enrich $2,500 - 20% Copay - HMO
  • Enrich $3,400 - 30% HDHP - HMO
  • Enrich $3,500 HDHP - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Prasanna Raman 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

  • 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

Physician 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 53589 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $82.92
  • Minimum New Patient Price $53.9
  • Maximum New Patient Price $163.24
  • Average New Patient Copayment $20.73
  • Minimum New Patient Copayment $13.47
  • Maximum New Patient Copayment $40.81

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $95.41
  • Minimum Established Patient Price $17.4
  • Maximum Established Patient Price $133.76
  • Average Established Patient Copayment $23.85
  • Minimum Established Patient Copayment $4.35
  • Maximum Established Patient Copayment $33.44

* 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.

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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 1609836709, we treat the final digit (9) 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 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

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.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
0
Doubled → 0
Pos 4
9
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
3
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
7
Unchanged
Pos 9
0
Doubled → 0
Check
9
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 0 → 0 8 → 16 → 7 6 → 12 → 3 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 0 + 9 + 1 + 6 + 3 + 1 + 2 + 7 + 0 + 24 = 61

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1609836709.

Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Durable Medical Equipment & Medical Supplies
1001 NYGAARD ST
STOUGHTON, WI 53589
Pediatrics
1001 NYGAARD ST
STOUGHTON, WI 53589
Internal Medicine
1001 NYGAARD ST
STOUGHTON, WI 53589
Pediatrics
1001 NYGAARD ST
STOUGHTON, WI 53589
Internal Medicine
1001 NYGAARD ST
STOUGHTON, WI 53589
Nurse Practitioner (Family)
1001 NYGAARD ST
STOUGHTON, WI 53589
Nurse Practitioner (Pediatrics)
1001 NYGAARD ST
STOUGHTON, WI 53589

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1609836709, enumerated as an "individual" on March 24, 2006.

The provider is located at 1001 NYGAARD ST STOUGHTON, WI 53589 and the phone number is (608) 877-2660.

Pediatrics with taxonomy code 208000000X.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Group Health. Please consult your insurance carrier or call the provider to verify.