DR. SAPNA PRABHAKARAN M.D
NPI 1992938534
Pediatrics in Saint Paul, MN

Active since August 31, 2009PECOS EnrolledAccepts Medicare Assignment
86.51/100
CMS Quality Rating
1700 UNIVERSITY AVE W, SAINT PAUL, MN 55104(612) 672-6000 Get Directions Write a Review

NPPES record last updated: November 14, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Sapna Prabhakaran M.d NPPES

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

DR. SAPNA PRABHAKARAN M.D (NPI 1992938534) is an individual pediatrics provider in Saint Paul, Minnesota, licensed in Minnesota (70087) and active in the NPI registry since August 2009. She is enrolled in Medicare PECOS, maintains a secondary practice location in Bronx, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1992938534
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. SAPNA PRABHAKARANCredential: M.D
Location Address1700 UNIVERSITY AVE WSaint Paul, MN 55104-3727
Mailing Address1700 University Ave WSaint Paul, MN 55104-3727
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateAugust 31, 2009
Last NPPES UpdateNovember 14, 2022
NPPES CertifiedNovember 14, 2022
NPI 1992938534 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses Licensed in MN · 70087 Licensed in NY · 253959
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1700 UNIVERSITY AVE W, Saint Paul, MN 55104

Secondary Practice Location 1

Location 12016 Bronxdale Ave, Suite 203Bronx, NY 10462-3388 · Phone (718) 597-0700

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

Dr. Sapna Prabhakaran 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 ID1052717311
PECOS Enrollment IDI20210913000194
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 43

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.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
633 services254 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
207 services85 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test 85027
A complete blood cell count (CBC) is an automated test that measures different components of the blood, including red cells, white cells, and platelets. It helps assess overall health, detect disorders like anemia or infection, and monitor medical treatments.
182 services59 patients
Blood test, basic group of blood chemicals (calcium, total) 80048
A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.
154 services68 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
151 services60 patients
X-ray of chest, 2 views 71046
A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.
105 services98 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55104 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
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.

86.51/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality82.59
Promoting Interoperability100
Improvement Activities40
Cost67.96

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.

Interpreter
1700 UNIVERSITY AVE W
SAINT PAUL, MN 55104
Nurse Practitioner (Gerontology)
1700 UNIVERSITY AVE W
SAINT PAUL, MN 55104
Interpreter
1700 UNIVERSITY AVE W
SAINT PAUL, MN 55104
Social Worker (Clinical)
1700 UNIVERSITY AVE W
SAINT PAUL, MN 55104
Nurse Practitioner (Gerontology)
1700 UNIVERSITY AVE W
SAINT PAUL, MN 55104
Dietitian, Registered
1700 UNIVERSITY AVE W
SAINT PAUL, MN 55104
Internal Medicine
1700 UNIVERSITY AVE W
SAINT PAUL, MN 55104
Interpreter
1700 UNIVERSITY AVE W
SAINT PAUL, MN 55104

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 Sapna Prabhakaran's NPI number?

The NPI number for Sapna Prabhakaran is 1992938534. It was assigned to this individual provider in the NPPES registry on August 31, 2009.

Where is Sapna Prabhakaran located?

Sapna Prabhakaran practices at 1700 University Ave W, Saint Paul, MN 55104. The listed phone number is (612) 672-6000.

What is Sapna Prabhakaran's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Sapna Prabhakaran enrolled in Medicare?

Yes. Sapna Prabhakaran 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 Sapna Prabhakaran accept?

Health plans from Medica and Sanford Health Plan list Sapna Prabhakaran 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.

When was this NPI record last updated?

The NPPES record for Sapna Prabhakaran was last updated on November 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.