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PRATYUSHA TANTRAVAHI D.O. NPI 1295198414


NPI Information

NPI: 1295198414
Provider Name: PRATYUSHA TANTRAVAHI, D.O.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Organization: PARKVIEW HEALTH SYSTEM INC

PECOS Registration: Yes

Address:
11109 PARKVIEW PLAZA DR
FORT WAYNE, IN
ZIP 46845
Phone: (260) 266-2020
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Pratyusha Tantravahi, D.O. is a family medicine in Fort Wayne, IN with 8 years of experience. The provider is 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. Pratyusha Tantravahi, D.O. NPI is 1295198414. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

11109 PARKVIEW PLAZA DR
FORT WAYNE, IN
ZIP 46845-701
Phone: (260) 266-2020
Fax: (260) 266-2009

The NPI 1295198414 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/4/2016 and was last updated on 9/18/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine02006015INDIANANo
2207Q00000XFamily Medicine15769NORTH DAKOTANo
3390200000XStudent in an Organized Health Care Education/Training ProgramNo
4207Q00000XFamily Medicine02006015AINDIANAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.