PRANAV BOLLAVARAM
NPI 1629658133
Student in an Organized Health Care Education/Training Program in Columbus, OH

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since April 09, 2021PECOS Enrolled

395 W 12TH AVE, COLUMBUS, OH 43210(614) 685-4411 Get Directions Write a Review

NPPES record last updated: August 8, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 8, 2022, Apr 9, 2021 (2 updates tracked since 2021).

On this page

About Pranav Bollavaram NPPES

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

PRANAV BOLLAVARAM (NPI 1629658133) is an individual student in an organized health care education/training program in Columbus, Ohio and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629658133

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NamePRANAV BOLLAVARAM

Location Address395 W 12TH AVEColumbus, OH 43210-1267

Mailing Address395 W 12th AveColumbus, OH 43210-1267

Phone(614) 685-4411

Sole ProprietorYes

Enumeration DateApril 9, 2021

Last NPPES UpdateAugust 8, 20222 updates tracked since enumeration

NPPES CertifiedAugust 8, 2022

✔ NPI 1629658133 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

395 W 12TH AVE, Columbus, OH 43210

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pranav Bollavaram is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.