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JOHN DAVID PROLOGO M.D. NPI 1558308379


NPI Information

NPI: 1558308379
Provider Name: JOHN DAVID PROLOGO, M.D.
Classification: Radiology - 2085R0204X
Entity Type: Individual

Specialization: Vascular & Interventional Radiology

PECOS Registration: Yes

Address:
1364 CLIFTON ROAD NE
SUITE D111
ATLANTA, GA
ZIP 30322
Phone: (404) 712-7033
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John David Prologo, M.D. is a vascular and interventional radiology radiology in Atlanta, GA with 23 years of experience. The provider is a radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. John David Prologo, M.D. NPI is 1558308379. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduation Year:2001

The provider's business location address is:

1364 CLIFTON ROAD NE
SUITE D111
ATLANTA, GA
ZIP 30322
Phone: (404) 712-7033
Fax: (404) 712-7970

The NPI 1558308379 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes (HCPCS:99152)
  • Radiological supervision and interpretation of ct guidance for needle insertion (HCPCS:77012)
  • Injection of substance into spinal canal of lower back or sacrum using imaging guidance (HCPCS:62323)

The enumeration date for this NPI number is 6/1/2006 and was last updated on 4/28/2015.


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
12085R0204XRadiologyVascular & Interventional Radiology72294GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1752765OTHEROHIOBUCKEYE
2PR4194083MEDICARE PINOHIO
3389288OTHEROHIOWELLCARE
42691823MEDICAIDOHIO
5000000516404OTHEROHIOANTHEM
6P00420609OTHEROHIORAILROAD MEDICARE
7000000230982OTHEROHIOUNISON
89808106OTHEROHIOAETNA

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: 4/28/2024

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.