SANDEEP GAJANAN PRABHU (MD) – Pediatric Radiology Physician, NPI 1689844797

SANDEEP GAJANAN PRABHU (MD) is a healthcare provider. based in Oklahoma city, Oklahoma. specializing in DIAGNOSTIC RADIOLOGY, INTERVENTIONAL RADIOLOGY. They hold the professional credentials MD. They hold a License No. 25469 (OK). The NPI Number for SANDEEP GAJANAN PRABHU (MD) is 1689844797

Main info

Male
Sole Proprietor
37 Years Of Experience
Accepts Medicare Assignment
Name
SANDEEP GAJANAN PRABHU (MD)
NPI
1689844797
Phone
(405) 271-5125
Address
1200 EVERETT DR
Enumeration Date
4 March 2008
Last Update Date
4 March 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1989 (37 years ago)
PAC ID
0941483838
Group Practice PAC ID
5991105876
Professional Enrollment ID
I20110330000982
Address ID
OK731044637OK1200XAVEX358
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

384 DIAGNOSTIC RADIOLOGY in OK

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Provider Addresses for SANDEEP GAJANAN PRABHU (MD)

  • Everett Drive, Oklahoma City, Oklahoma County, Oklahoma, 73013, United States

    1NP606

    OKLAHOMA CITY, OK 731045047

    Phone: (405) 271-5125

    Type: Location

  • 940, Stanton L Young Boulevard, Oklahoma City, Oklahoma County, Oklahoma, 73117, United States

    BMSB 357

    OKLAHOMA CITY, OK 731045020

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $27.

Total Amount is formed as General ($27) + Research ($0) + Ownership ($0) = $27.

Last reported payment date: 2023-09-27 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($14).

Total Amount

$27

General + Research + Ownership

Payments

2

Total payment records

General Amount

$27

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-09-27

Latest reported date

Top Companies

Largest payers in this snapshot

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-03-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110330000982IDiagnostic RadiologyOKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 73104)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991105876View full group profile
NameSpecialtyState
Diagnostic RadiologyOK
O P H T H A L M O L O G YOK
Certified Registered Nurse Anesthetist (Crna)OK
R H E U M A T O L O G YOK
Nurse PractitionerOK
Certified Registered Nurse Anesthetist (Crna)OK
Certified Registered Nurse Anesthetist (Crna)OK
Family Practice, HospitalistOK
Medical OncologyRI
Clinical Social WorkerOK

Reviews

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Frequently asked questions

How do I look up SANDEEP GAJANAN PRABHU (MD) by NPI?
Use NPI 1689844797 when you need to reference SANDEEP GAJANAN PRABHU (MD) in forms, claims, or directories.
Is SANDEEP GAJANAN PRABHU (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize SANDEEP GAJANAN PRABHU (MD)'s specialty in plain language?
Clinically, the directory lists SANDEEP GAJANAN PRABHU (MD) with Pediatric Radiology Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for SANDEEP GAJANAN PRABHU (MD)?
The page summarizes Oklahoma City, Oklahoma for SANDEEP GAJANAN PRABHU (MD); expand the address list for detail.
Is SANDEEP GAJANAN PRABHU (MD) a real provider?
This page reflects official NPPES data for NPI 1689844797. Always confirm identity and privileges with the practice and licensing boards.

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