Praveen Rajanahalli, MD is a medicare enrolled "General Practice" physician in Greenwood, Indiana. His current practice location is
701 E County Line Rd Ste 210, Greenwood, Indiana. You can reach out to his office (for appointments etc.) via phone at
(317) 300-7424.
Praveen Rajanahalli is licensed to practice in Indiana (license number 01067143A) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1497925572.
Physician's Profile
Full Name | Praveen Rajanahalli |
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Gender | Male |
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Speciality | General Practice |
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Location | 701 E County Line Rd Ste 210, Greenwood, Indiana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1497925572
- Provider Enumeration Date: 03/05/2008
- Last Update Date: 04/01/2019
Medicare PECOS Information:
- PECOS PAC ID: 2365636669
- Enrollment ID: I20101101000480
Medical Identifiers
Medical identifiers for Praveen Rajanahalli such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1497925572 | NPI | - | NPPES |
200961530 | Medicaid | IN | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208D00000X | General Practice | 11013162A (Indiana) | Secondary |
208D00000X | General Practice | 01067143A (Indiana) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Praveen Rajanahalli allows following entities to bill medicare on his behalf.
Entity Name | Altus Direct, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1750829230 PECOS PAC ID: 8921383605 Enrollment ID: O20170320001957 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Praveen Rajanahalli is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Praveen Rajanahalli, MD 701 E County Line Rd Ste 210, Greenwood, IN 46143-1071 Ph: (317) 300-7424 | Praveen Rajanahalli, MD 701 E County Line Rd Ste 210, Greenwood, IN 46143 Ph: (317) 300-7424 |
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