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PRASUNA MADHAVARAM MD
NPI 1952525115
Internal Medicine - Endocrinology, Diabetes & Metabolism in Cedar Rapids, IA

Active since April 12, 2007PECOS EnrolledAccepts Medicare Assignment
621 HUNTINGTON RIDGE RD NE, CEDAR RAPIDS, IA 52402(501) 258-4426 Get Directions Write a Review

NPPES record last updated: September 12, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Prasuna Madhavaram Md NPPES

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

PRASUNA MADHAVARAM MD (NPI 1952525115) is an individual endocrinology, diabetes & metabolism provider in Cedar Rapids, Iowa, licensed in Iowa (40130) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS, is affiliated with St Lukes Hospital, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1952525115
Entity TypeIndividualFemale
Primary Taxonomy207RE0101X
Provider Legal NamePRASUNA MADHAVARAMCredential: MD
Location Address621 HUNTINGTON RIDGE RD NECedar Rapids, IA 52402-7308
Mailing Address621 Huntington Ridge Rd NeCedar Rapids, IA 52402-7308 · (501) 258-4426
Phone(501) 258-4426
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateApril 12, 2007
Last NPPES UpdateSeptember 12, 2013
✔ NPI 1952525115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in IA · 40130
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
621 HUNTINGTON RIDGE RD NE, Cedar Rapids, IA 52402
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.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

Prasuna Madhavaram 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 ID5193978914
PECOS Enrollment IDI20130103000303
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.

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.
368 services330 patients
Diabetes outpatient self-management training services, individual, per 30 minutes G0108
This service involves personalized training sessions, each lasting 30 minutes, to help manage diabetes. It includes guidance on monitoring blood sugar, healthy eating, physical activity, medication usage, and dealing with daily challenges of living with diabetes.
228 services88 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
83 services63 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.
73 services73 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
34 services32 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin 95249
Continuous monitoring of blood sugar involves a small sensor inserted under the skin. This sensor measures glucose levels in tissue fluid throughout the day and night, providing real-time readings. It aids in managing diabetes effectively.
24 services24 patients

Hospital Affiliations CMS Care Compare 5

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

St Lukes Hospital

Acute Care Hospitals · Cedar Rapids, IA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number160045
Location1026 A Ave NECedar Rapids, IA 52402 · Linn County
Emergency services Birthing friendly

Pocahontas Community Hospital

Critical Access Hospitals · Pocahontas, IA
OwnershipGovernment - Local
CMS Certification Number161305
Location606 N W 7th StreetPocahontas, IA 50574 · Pocahontas County
Emergency services

Jones Regional Medical Center

Critical Access Hospitals · Anamosa, IA
OwnershipVoluntary non-profit - Private
CMS Certification Number161306
Location1795 Highway 64 EastAnamosa, IA 52205 · Jones County
Emergency services

Regional Medical Center

Critical Access Hospitals · Manchester, IA
OwnershipGovernment - Local
CMS Certification Number161343
Location709 W Main StreetManchester, IA 52057 · Delaware County
Emergency services

Virginia Gay Hospital

Critical Access Hospitals · Vinton, IA
OwnershipVoluntary non-profit - Private
CMS Certification Number161349
Location502 North 9th AvenueVinton, IA 52349 · Benton County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 52402 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
$122.23 typical visit price
range $52.96 – $161.40
Typical copayment $30.55 (range $13.24 – $40.35)
Most-billed visit code 99204
Established Patient
$94.05 typical visit price
range $16.91 – $131.98
Typical copayment $23.51 (range $4.22 – $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.

Referred Medical Equipment & Supplies CMS DME claims 6

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

Supplies for maintenance of insulin infusion catheter, per week A4224
DME-Other DME · category DE017N
5 suppliers14 claims181 services$17.15 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
4 suppliers12 claims445 services$2.36 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
15 suppliers40 claims128 services$6.28 avg. paid by Medicare
Insulin for administration through dme (i.e., insulin pump) per 50 units J1817
Treatment-Injections and Infusions (nononcologic) · category RI000N
5 suppliers19 claims2,230 services$7.02 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
16 suppliers451 claims453 services$178.97 avg. paid by Medicare
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system K0554
DME-Other DME · category DE017N
4 suppliers13 claims13 services$206.87 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Prasuna Madhavaram's NPI number?

The NPI number for Prasuna Madhavaram is 1952525115. It was assigned to this individual provider in the NPPES registry on April 12, 2007.

Where is Prasuna Madhavaram located?

Prasuna Madhavaram practices at 621 Huntington Ridge Rd NE, Cedar Rapids, IA 52402. The listed phone number is (501) 258-4426.

What is Prasuna Madhavaram's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Prasuna Madhavaram enrolled in Medicare?

Yes. Prasuna Madhavaram 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 Prasuna Madhavaram accept?

Health plans from Medica list Prasuna Madhavaram 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 Prasuna Madhavaram affiliated with any hospitals?

According to CMS data, Prasuna Madhavaram is affiliated with St Lukes Hospital, Pocahontas Community Hospital, Jones Regional Medical Center, Regional Medical Center and Virginia Gay Hospital.

When was this NPI record last updated?

The NPPES record for Prasuna Madhavaram was last updated on September 12, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.