PRAFULL RAHEJA M.D.
NPI 1679732051
Internal Medicine - Interventional Cardiology in Louisville, KY

Q: What is Prafull Raheja's NPI number?

The NPI number for Prafull Raheja is 1679732051. It was assigned to this individual provider in the NPPES registry on June 2, 2008.

Q: What is Prafull Raheja's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.

Q: When was this NPI record last updated?

The NPPES record for Prafull Raheja was last updated on November 14, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.

Active since June 02, 2008PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

201 ABRAHAM FLEXNER WAY, SUITE 1101, LOUISVILLE, KY 40202(502) 581-1951(502) 540-5137 Get Directions Write a Review

NPPES record last updated: November 14, 2016. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Nov 14, 2016, Jul 13, 2016, Jun 13, 2016 and 1 more (4 updates tracked since 2016).

On this page

About Prafull Raheja M.d. NPPES

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

PRAFULL RAHEJA M.D. (NPI 1679732051) is an individual interventional cardiology provider in Louisville, Kentucky, licensed in Kentucky (44271) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Hardin, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1679732051

Entity TypeIndividualMale

Primary Taxonomy207RI0011X

Provider Legal NamePRAFULL RAHEJACredential: M.D.

Location Address201 ABRAHAM FLEXNER WAY, SUITE 1101Louisville, KY 40202-3841

Mailing Address100 E Liberty St, Suite 800 - Business OfficeLouisville, KY 40202-1434 · (502) 581-1951 · Fax (502) 540-5137

Phone(502) 581-1951

Fax(502) 540-5137

Sole ProprietorNo

Medical School CMSOtherGraduated 2005

Enumeration DateJune 2, 2008

Last NPPES UpdateNovember 14, 20164 updates tracked since enumeration

✔ NPI 1679732051 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Interventional CardiologyAllopathic & Osteopathic Physicians

Taxonomy Code207RI0011X

License✔ Licensed in KY · 44271

Definition

An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.

Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X · License 44271 (KY)

201 ABRAHAM FLEXNER WAY, Louisville, KY 40202

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Other Identifiers 4

Medicaid201363930A (KOHMG)IN

Medicare PINP01661845 RR (KOHMG)KY

Medicare PINK202930 (KOHMG)KY

Medicaid7100425760 (KOHMG)KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.Insurance ›

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

Prafull Raheja 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 ID7618283490

PECOS Enrollment IDI20160520001502

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 22

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.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

1,324 services932 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.

507 services267 patients

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.

394 services277 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.

123 services119 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

98 services90 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

89 services89 patients

Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist 93458

This procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.

80 services77 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

66 services62 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

58 services57 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

47 services46 patients

Ultrasound evaluation of heart blood vessel or graft with review by radiologist, initial vessel 92978

This procedure involves using ultrasound technology to examine the first vessel of your heart or graft. A radiologist will review the images. It's a non-invasive way to check the health of your heart's blood vessels.

41 services37 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

37 services37 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital 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.

37 services36 patients

Insertion of tube in right and left heart chambers and coronary artery for diagnosis with review by radiologist 93460

This procedure involves placing a tube into the heart chambers and coronary artery. It helps diagnose heart conditions. A radiologist reviews the images obtained. It's a standard, safe procedure performed by experienced medical professionals.

28 services28 patients

Ultrasound evaluation of heart blood vessel during diagnosis or treatment, initial vessel 93571

This procedure involves using ultrasound technology to examine the first blood vessel of your heart. It helps identify any abnormalities or issues, providing crucial information for diagnosis or treatment. It's a safe, non-invasive process.

27 services27 patients

Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch 92928

This procedure involves placing a small, mesh tube (stent) in your coronary artery to keep it open. A balloon is used to expand the stent and artery, improving blood flow to your heart. It's typically done for a single artery or branch.

23 services21 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

19 services18 patients

Ultrasound of heart blood flow, valves and chambers, follow-up 93321

This procedure, an echocardiogram, uses sound waves to create images of your heart. It aids in assessing your heart's blood flow, chambers, and valves. It's a follow-up procedure, ensuring that your heart is functioning properly post-treatment.

17 services16 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.

16 services16 patients

Replacement of aortic valve through the skin and femoral artery 33361

This procedure, known as Transcatheter Aortic Valve Replacement (TAVR), involves replacing a damaged aortic valve through a small incision in the leg. A catheter is inserted into the femoral artery and guided up to the heart. The new valve is then positioned and deployed, restoring normal blood flow.

14 services14 patients

Heart rhythm recording of continous external ekg over 8-15 days 93246

A heart rhythm recording is a non-invasive procedure where a small device, attached externally, monitors your heart's electrical activity for 8-15 days. It helps detect irregular heart rhythms, assess heart rate, and guide treatment decisions. It's safe, painless, and can be done during normal daily activities.

12 services12 patients

Heart rhythm review and interpretation of continous external ekg over 8-15 days 93248

This service involves wearing a device for 8-15 days that continuously records your heart's electrical activity. It helps in identifying irregular heart rhythms. The recorded data is then reviewed and interpreted by a healthcare professional for any abnormalities.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Baptist Health Hardin

Acute Care Hospitals · Elizabethtown, KY

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number180012

Location913 North Dixie AvenueElizabethtown, KY 42701 · Hardin County

Emergency services

Uofl Health - Shelbyville Hospital

Acute Care Hospitals · Shelbyville, KY

OwnershipVoluntary non-profit - Private

CMS Certification Number180016

Location727 Hospital DriveShelbyville, KY 40065 · Shelby County

Emergency services

Jewish Hospital & St Mary's Healthcare

Acute Care Hospitals · Louisville, KY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180040

Location200 Abraham Flexner WayLouisville, KY 40202 · Jefferson County

Emergency services

Taylor Regional Hospital

Acute Care Hospitals · Campbellsville, KY

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number180087

Location1700 Old Lebanon RoadCampbellsville, KY 42718 · Taylor County

Emergency services

Norton Hospitals, Inc

Acute Care Hospitals · Louisville, KY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180088

Location200 East Chestnut StreetLouisville, KY 40202 · Jefferson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40202 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

$122.77 typical visit price

range $52.76 – $162.27

Typical copayment $30.69 (range $13.19 – $40.56)

Most-billed visit code 99204

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

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.

75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Other Providers at the Same Location NPPES 20

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

DR. MARTHA TRIMBLE MCCOY M.D.

Surgery

201 ABRAHAM FLEXNER WAY, STE 902
LOUISVILLE, KY 40202

Jefferson County (502) 583-5945

RAYMOND G SHEA MD PSC

Orthopaedic Surgery

201 ABRAHAM FLEXNER WAY, SUITE 100
LOUISVILLE, KY 40202

Jefferson County (502) 587-8222

MRS. CHRISTIN E HONAKER MD

Internal Medicine

201 ABRAHAM FLEXNER WAY, SUITE 904
LOUISVILLE, KY 40202

Jefferson County (502) 589-3844

MS. HEATHER J MOODY APRN

Nurse Practitioner (Acute Care)

201 ABRAHAM FLEXNER WAY, SUITE 1200
LOUISVILLE, KY 40202

Jefferson County (502) 583-8383

SUDHIR NARAIN MD

Internal Medicine

201 ABRAHAM FLEXNER WAY, #1001
LOUISVILLE, KY 40202

Jefferson County (502) 589-6788

LAUREN MICHELLE HAMILTON APRN

Nurse Practitioner (Critical Care Medicine)

201 ABRAHAM FLEXNER WAY
LOUISVILLE, KY 40202

Jefferson County (502) 588-7600

DALE M. ROBERTS MD

Plastic Surgery

201 ABRAHAM FLEXNER WAY, SUITE 1105
LOUISVILLE, KY 40202

Jefferson County (502) 581-9223

VRINDA SARDANA M.D.

Internal Medicine (Cardiovascular Disease)

201 ABRAHAM FLEXNER WAY, SUITE 1101
LOUISVILLE, KY 40202

Jefferson County (502) 581-1951

ARTHUR LALIT/LAXMAN MALKANI M.D.

Orthopaedic Surgery

201 ABRAHAM FLEXNER WAY, SUITE 100
LOUISVILLE, KY 40202

Jefferson County (502) 587-8222

EDUARDO ULFE CFA

Specialist/Technologist Cardiovascular (Cardiovascular Invasive Specialist)

201 ABRAHAM FLEXNER WAY, SUITE 1200
LOUISVILLE, KY 40202

Jefferson County (502) 561-2180

REBECCA ERVIN DAVIS

Family Medicine

201 ABRAHAM FLEXNER WAY, SUITE 690
LOUISVILLE, KY 40202

Jefferson County (502) 852-0132

VICTOR HENRY VANBERKEL MD PHD

Thoracic Surgery (Cardiothoracic Vascular Surgery)

201 ABRAHAM FLEXNER WAY, SUITE 1200
LOUISVILLE, KY 40202

Jefferson County (502) 583-8383

RAUL NAKAMATSU MD

Internal Medicine (Infectious Disease)

201 ABRAHAM FLEXNER WAY
LOUISVILLE, KY 40202

Jefferson County (502) 852-5131

STEPHEN J WINTERS MD

Internal Medicine (Endocrinology, Diabetes & Metabolism)

201 ABRAHAM FLEXNER WAY
LOUISVILLE, KY 40202

Jefferson County (502) 587-4500

MRS. MARGARET E. POPP APRN-NP

Nurse Practitioner

201 ABRAHAM FLEXNER WAY, SUITE 100
LOUISVILLE, KY 40202

Jefferson County (502) 587-8222

JANE ANN KUHN ARNP

Nurse Practitioner

201 ABRAHAM FLEXNER WAY, SUIT3 1004
LOUISVILLE, KY 40202

Jefferson County (502) 589-3173

MONICA SHAW MD

Internal Medicine

201 ABRAHAM FLEXNER WAY
LOUISVILLE, KY 40202

Jefferson County (502) 589-6788

BARBARA CASPER MD

Internal Medicine

201 ABRAHAM FLEXNER WAY, 1001
LOUISVILLE, KY 40202

Jefferson County (502) 589-6788

JENNIFER KOCH MD

Internal Medicine

201 ABRAHAM FLEXNER WAY, 220
LOUISVILLE, KY 40202

Jefferson County (502) 589-6788

FOREST ARNOLD DO

Internal Medicine (Infectious Disease)

201 ABRAHAM FLEXNER WAY
LOUISVILLE, KY 40202

Jefferson County (502) 852-5131

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 Prafull Raheja's NPI number?

The NPI number for Prafull Raheja is 1679732051. It was assigned to this individual provider in the NPPES registry on June 2, 2008.

Where is Prafull Raheja located?

Prafull Raheja practices at 201 Abraham Flexner Way Suite 1101, Louisville, KY 40202. The listed phone number is (502) 581-1951.

What is Prafull Raheja's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.

Is Prafull Raheja enrolled in Medicare?

Yes. Prafull Raheja 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.

What insurance does Prafull Raheja accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield and 1 other insurer list Prafull Raheja as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Prafull Raheja affiliated with any hospitals?

According to CMS data, Prafull Raheja is affiliated with Baptist Health Hardin, UofL Health - Shelbyville Hospital, Jewish Hospital & St Mary's Healthcare, Taylor Regional Hospital and Norton Hospitals, Inc.

When was this NPI record last updated?

The NPPES record for Prafull Raheja was last updated on November 14, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.