RAJESH PRADHAN MD
NPI 1912115841
Internal Medicine - Cardiovascular Disease in Rapid City, SD

Active since May 21, 2007PECOS EnrolledAccepts Medicare Assignment
97.58/100
CMS Quality Rating
4150 5TH ST, RAPID CITY, SD 57701(605) 399-4300(605) 399-4352 Get Directions Write a Review

NPPES record last updated: September 11, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Rajesh Pradhan Md NPPES

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

RAJESH PRADHAN MD (NPI 1912115841) is an individual cardiovascular disease provider in Rapid City, South Dakota, licensed in South Dakota (8686) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Monument Health Spearfish Hospital, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1912115841
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameRAJESH PRADHANCredential: MD
Location Address4150 5TH STRapid City, SD 57701-6022
Mailing Address353 Fairmont Blvd, Atten Christie MssRapid City, SD 57701-7350 · (605) 399-4300
Fax(605) 399-4352
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateMay 21, 2007
Last NPPES UpdateSeptember 11, 2019
NPI 1912115841 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License Licensed in SD · 8686
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
4150 5TH ST, Rapid City, SD 57701

Accepted 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

Rajesh Pradhan Md 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 ID8729133871
PECOS Enrollment IDI20130923000790, I20140116000723, I20190312001685
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 27

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.
1,555 services1,306 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.
784 services777 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.
314 services263 patients
Ultrasound of heart with color-depicted blood flow, rate and valve function 93325
An ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.
232 services212 patients
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.
219 services208 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.
191 services177 patients

Hospital Affiliations CMS Care Compare 5

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

Monument Health Spearfish Hospital

Acute Care Hospitals · Spearfish, SD
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number430048
Location1440 N Main StSpearfish, SD 57783 · Lawrence County
Emergency services

Monument Health Rapid City Hospital

Acute Care Hospitals · Rapid City, SD
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number430077
Location353 Fairmont BlvdRapid City, SD 57701 · Pennington County
Emergency services Birthing friendly

Monument Health Sturgis Hospital

Critical Access Hospitals · Sturgis, SD
OwnershipVoluntary non-profit - Other
CMS Certification Number431321
Location2140 Junction AveSturgis, SD 57785 · Meade County
Emergency services

Fall River Hospital - Cah

Critical Access Hospitals · Hot Springs, SD
OwnershipGovernment - Local
CMS Certification Number431322
Location1201 Highway 71 SouthHot Springs, SD 57747 · Fall River County
Emergency services

Monument Health Custer Hospital

Critical Access Hospitals · Custer, SD
OwnershipVoluntary non-profit - Private
CMS Certification Number431323
Location1220 Montgomery StreetCuster, SD 57730 · Custer County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 57701 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
$126.78 typical visit price
range $55.52 – $167.23
Typical copayment $31.69 (range $13.88 – $41.80)
Most-billed visit code 99204
Established Patient
$69.20 typical visit price
range $18.08 – $137.08
Typical copayment $17.30 (range $4.52 – $34.27)
Most-billed visit code 99213
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.

97.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.53
Promoting Interoperability100
Improvement Activities40

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.

Nurse Practitioner
4150 5TH ST
RAPID CITY, SD 57701
Physician Assistant
4150 5TH ST
RAPID CITY, SD 57701
Nurse Practitioner (Family)
4150 5TH ST
RAPID CITY, SD 57701
Nurse Practitioner (Family)
4150 5TH ST
RAPID CITY, SD 57701
Internal Medicine (Cardiovascular Disease)
4150 5TH ST
RAPID CITY, SD 57701
Nurse Practitioner (Family)
4150 5TH ST
RAPID CITY, SD 57701
Nurse Practitioner
4150 5TH ST
RAPID CITY, SD 57701
Physician Assistant
4150 5TH ST
RAPID CITY, SD 57701

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 Rajesh Pradhan's NPI number?

The NPI number for Rajesh Pradhan is 1912115841. It was assigned to this individual provider in the NPPES registry on May 21, 2007.

Where is Rajesh Pradhan located?

Rajesh Pradhan practices at 4150 5th St, Rapid City, SD 57701. The listed phone number is (605) 399-4300.

What is Rajesh Pradhan's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Rajesh Pradhan enrolled in Medicare?

Yes. Rajesh Pradhan 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 Rajesh Pradhan accept?

Health plans from Avera Health Plans, Medica, Oscar Insurance Company and Sanford Health Plan list Rajesh Pradhan 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 Rajesh Pradhan affiliated with any hospitals?

According to CMS data, Rajesh Pradhan is affiliated with Monument Health Spearfish Hospital, Monument Health Rapid City Hospital, Monument Health Sturgis Hospital, Fall River Hospital - Cah and Monument Health Custer Hospital.

When was this NPI record last updated?

The NPPES record for Rajesh Pradhan was last updated on September 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.