PRASAD JOHNSON RAJU PILLI M.D.
NPI 1740554088
Family Medicine in Harlingen, TX
NPI Status: Active since March 05, 2012
Contact Information
2121 PEASE ST
SUITE 201
HARLINGEN, TX
ZIP 78550
Phone: (956) 389-1940
Fax: (956) 389-1341
- NPI Profile Information
- Primary Taxonomy
- Insurance Plans Accepted
- Secondary Locations
- Medicare Participation & PECOS Status
- Areas of Expertise
- Durable Medical Equipment
- Physician Visit Costs
- Quality Reporting
- Hospital Affiliations - Privileges
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
- Individual
- Male
- Years of Experience 27
- Family Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About PRASAD PILLI
This page provides the complete NPI Profile along with additional information for Prasad Pilli, a primary care provider established in Harlingen, Texas with a medical specialization in Family Medicine and more than 27 years of experience. The healthcare provider is registered in the NPI registry with number 1740554088 assigned on March 2012. The practitioner's primary taxonomy code is 207Q00000X with license number P3566 (TX). The provider is registered as an individual and his NPI record was last updated 5 years ago.
- NPI
- 1740554088
- Provider Name
- PRASAD JOHNSON RAJU PILLI M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2121 PEASE ST SUITE 201 HARLINGEN, TX 78550
- Location Phone
- (956) 389-1940
- Location Fax
- (956) 389-1341
- Mailing Address
- PO BOX 3230 HARLINGEN, TX 78551
- Mailing Phone
- (956) 389-1940
- Mailing Fax
- (956) 389-1341
- Medical School Name
- OTHER
- Graduation Year
- 2000
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 03-05-2012
- Last Update Date
- 02-05-2021
- Code Navigator
A primary care provider (PCP) like Prasad Pilli sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
Secondary Locations
- 597 W Sesame Dr Ste B
Harlingen, TX 78550
(956) 254-6261
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
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- P3566
- License State
- TX
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- Blue Advantage Plus Gold? 803 - POS
- Blue Advantage Plus Gold? Standard - POS
- Blue Advantage Plus Silver? 202 - POS
- Blue Advantage Plus Silver? 605 - POS
- Blue Advantage Plus Silver? Standard - POS
- Blue Advantage Security HMO? 200 - HMO
- Blue Advantage Silver HMO? 205 - HMO
- Blue Advantage Silver HMO? 801 - HMO
- Blue Advantage Silver HMO? Standard - HMO
- MyBlue Health Bronze? 402 - HMO
- Molina Gold Core 1640 - HMO
- Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
- Molina Gold Core 1640 Plus with Adult Vision - HMO
- Molina Gold Saver 750 - HMO
- Molina Gold Saver 750 Plus with Adult Dental and Vision - HMO
- Molina Gold Saver 750 Plus with Adult Vision - HMO
- Molina Gold Standard - HMO
- Molina Silver Core - HMO
- Molina Silver Core Plus with Adult Dental and Vision - HMO
- Molina Silver Core Plus with Adult Vision - HMO
- Molina Silver Saver with Four Free PCP Visits - HMO
- Molina Silver Standard - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Bronze Essential ($0 Virtual Urgent Care) - HMO
- UHC Bronze Standard - HMO
- UHC Bronze Standard+ (Dental + Vision) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
- UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision) - HMO
- UHC Gold Standard - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision) - HMO
- UHC Silver Standard - HMO
- UHC Silver Value ($0 Virtual Urgent Care) - HMO
- UHC Silver Value+ ($0 Virtual Urgent Care, Dental + Vision) - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 311576803 | MEDICAID (05) | TX |
Medicare Participation & PECOS Enrollment Status
Prasad Pilli is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Prasad Pilli 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
PECOS PAC ID: 6204084403
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20120913000033
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.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
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Medical/Surgical Supplies (DA000N)
Tape, waterproof, per 18 square inches (HCPCS:A4452)
4 DME suppliers used 18 Medicare Claims 1000 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing (HCPCS:A6196)
3 DME suppliers used 16 Medicare Claims 540 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6216)
3 DME suppliers used 22 Medicare Claims 4940 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard (HCPCS:A6443)
2 DME suppliers used 12 Medicare Claims 1380 Services Paid
DME-Hospital Beds (DB000N)
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress (HCPCS:E0261)
1 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Hospital Beds (DB000N)
Powered pressure-reducing air mattress (HCPCS:E0277)
1 DME suppliers used 27 Medicare Claims 27 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 30-39 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Grafix core and grafixpl core, per square centimeter
New patient office or other outpatient visit, 45-59 minutes
Preparation of skin graft site of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less
Removal of skin and tissue, 20.0 sq cm or less
Removal of skin and tissue, 20.0 sq cm or less
Removal of skin and tissue, each additional 20.0 sq cm or less
This procedure involves applying a skin substitute graft to a wound on the trunk, arms, or legs. The graft, a lab-grown skin, is used to cover a wound area of 25.0 sq cm or less, within a total wound area of 100.0 sq cm or less. It aids in healing and regeneration.
This service was performed 102 times for 15 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 163 times for 55 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 18 times for 14 patientsThis 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.
This service was performed 37 times for 27 patientsThis 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.
This service was performed 19 times for 18 patientsFollow-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.
This service was performed 12 times for 12 patientsGrafix CORE and GrafixPL CORE are advanced wound care options. They are bioengineered products derived from human placental tissues. These products are designed to support the body's natural healing process by providing a protective environment for the wound and promoting cell growth.
This service was performed 2,893 times for 17 patientsThis 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.
This service was performed 41 times for 41 patientsThis procedure involves preparing a specific area of the body (trunk, arms, or legs) for a skin graft. The area is cleaned and any dead tissue is removed to ensure a successful graft. The procedure covers an area of 100.0 sq cm or 1% of a child's body.
This service was performed 14 times for 14 patientsThis procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.
This service was performed 641 times for 85 patientsThis procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.
This service was performed 111 times for 16 patientsThis procedure involves the removal of skin and tissue, typically due to disease, injury, or abnormal growth. Each session removes an area of 20.0 square cm or less. It's performed by a trained professional and may require multiple sessions for larger areas.
This service was performed 262 times for 38 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.23 for a new patient copayment and $24.26 for an established patient copayment.
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 78550 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.92
- Minimum New Patient Price $54.84
- Maximum New Patient Price $166.88
- Average New Patient Copayment $21.23
- Minimum New Patient Copayment $13.71
- Maximum New Patient Copayment $41.72
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $97.05
- Minimum Established Patient Price $17.52
- Maximum Established Patient Price $136.11
- Average Established Patient Copayment $24.26
- Minimum Established Patient Copayment $4.38
- Maximum Established Patient Copayment $34.02
* 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.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
| Use of QCDR to support clinical decision making | Yes | N/A |
| Participation in a QCDR, demonstrating performance of activities that promote implementation of shared clinical decision making capabilities. | ||
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Prasad Pilli is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| VHS HARLINGEN HOSPITAL COMPANY LLC | 2101 PEASE ST HARLINGEN, TX 78550 | (956) 389-1100 | Acute Care Hospitals |
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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 1740554088, we treat the final digit (8) 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 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 62 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
HARLINGEN, TX 78550
HARLINGEN, TX 78550
HARLINGEN, TX 78550
HARLINGEN, TX 78550
HARLINGEN, TX 78550
HARLINGEN, TX 78550
HARLINGEN, TX 78550
HARLINGEN, TX 78550
HARLINGEN, TX 78550
HARLINGEN, TX 78550
HARLINGEN, TX 78550
HARLINGEN, TX 78550
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1740554088, enumerated as an "individual" on March 05, 2012.
The provider is located at 2121 PEASE ST SUITE 201 HARLINGEN, TX 78550 and the phone number is (956) 389-1940.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas, Molina. Please consult your insurance carrier or call the provider to verify.
Prasad Pilli is affiliated with: VHS HARLINGEN HOSPITAL COMPANY LLC.
