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DR. PRACHI AVINASH POPHALI MD
NPI 1689110611
Internal Medicine in Waukesha, WI

Active since January 14, 2017PECOS Enrolled
725 AMERICAN AVE, WAUKESHA, WI 53188(262) 928-5400 Get Directions Write a Review

NPPES record last updated: September 13, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 22, 2019, Jul 23, 2019, Jan 14, 2017 (3 updates tracked since 2017).

About Dr. Prachi Avinash Pophali Md NPPES

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

DR. PRACHI AVINASH POPHALI MD (NPI 1689110611) is an individual internal medicine provider in Waukesha, Wisconsin, licensed in Missouri (2019032520) and active in the NPI registry since January 2017. She is enrolled in Medicare PECOS, is affiliated with Waukesha Memorial Hospital, and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1689110611
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. PRACHI AVINASH POPHALICredential: MD
Location Address725 AMERICAN AVEWaukesha, WI 53188-5099
Mailing Address240 Easton Ave, 4th Floor Cares, Rm 4014New Brunswick, NJ 08901-1723 · (913) 548-3576
Phone(262) 928-5400
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateJanuary 14, 2017
Last NPPES UpdateSeptember 13, 20233 updates tracked since enumeration
NPPES CertifiedSeptember 13, 2023
✔ NPI 1689110611 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MO · 2019032520
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
725 AMERICAN AVE, Waukesha, WI 53188
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Secondary Practice Locations 4

Location 1240 Easton Ave, 4th Floor CARES, Rm 4014New Brunswick, NJ 08901-1723 · Phone (913) 548-3576
Location 2240 Maple AveMukwonago, WI 53149-8475 · Phone (262) 521-7761
Location 33100 Oak Grove RdPoplar Bluff, MO 63901-1573 · Phone (573) 785-7721
Location 4791 Summit AveOconomowoc, WI 53066-3896 · Phone (262) 569-0259

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Prachi Avinash Pophali Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7214266030
PECOS Enrollment IDI20221208002905
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 7

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 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.
282 services118 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.
103 services98 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.
61 services61 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
36 services25 patients
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.
30 services19 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
15 services15 patients

Hospital Affiliations CMS Care Compare 2

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

Waukesha Memorial Hospital

Acute Care Hospitals · Waukesha, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520008
Location725 American AveWaukesha, WI 53188 · Waukesha County
Emergency services Birthing friendly

Oconomowoc Memorial Hospital

Acute Care Hospitals · Oconomowoc, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520062
Location791 E Summit AveOconomowoc, WI 53066 · Waukesha County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53188 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
2 suppliers16 claims16 services$63.18 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
5 suppliers62 claims62 services$18.76 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers14 claims14 services$8.91 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
5 suppliers73 claims73 services$103.55 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 20

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

MS. NATASHA JEAN PINKERTON LCSW
Social Worker (Clinical)
725 AMERICAN AVE
WAUKESHA, WI 53188
Waukesha County (262) 928-1000
DR. FRANCISCO PEREZ M.D.
Anesthesiology
725 AMERICAN AVE
WAUKESHA, WI 53188
Waukesha County (262) 544-2011
ANNETTE QUINN NP
Nurse Practitioner (Obstetrics & Gynecology)
725 AMERICAN AVE, PROHEALTH CARE WOMEN'S CENTER
WAUKESHA, WI 53188
Waukesha County (262) 928-3500
ELIZABETH ROSE LEMM PA-C
Physician Assistant
725 AMERICAN AVE
WAUKESHA, WI 53188
Waukesha County (262) 928-1000
DR. JASON GEORGE ULRICHS M.D.
Anesthesiology
725 AMERICAN AVE
WAUKESHA, WI 53188
Waukesha County (262) 787-6700
DAWN MICHELLE GOODREAU NNP-BC, APNP
Nurse Practitioner (Neonatal)
725 AMERICAN AVE
WAUKESHA, WI 53188
Waukesha County (210) 685-0887
KAYLA DAVIS APNP
Nurse Practitioner (Acute Care)
725 AMERICAN AVE
WAUKESHA, WI 53188
Waukesha County (262) 928-1000
DR. ALYSSA JELINEK
Nurse Practitioner (Neonatal)
725 AMERICAN AVE
WAUKESHA, WI 53188
Waukesha County (262) 928-1000

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 Prachi Pophali's NPI number?

The NPI number for Prachi Pophali is 1689110611. It was assigned to this individual provider in the NPPES registry on January 14, 2017.

Where is Prachi Pophali located?

Prachi Pophali practices at 725 American Ave, Waukesha, WI 53188. The listed phone number is (262) 928-5400.

What is Prachi Pophali's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Prachi Pophali enrolled in Medicare?

Yes. Prachi Pophali is registered in the Medicare PECOS enrollment system.

Is Prachi Pophali affiliated with any hospitals?

According to CMS data, Prachi Pophali is affiliated with Waukesha Memorial Hospital and Oconomowoc Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Prachi Pophali was last updated on September 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.