Phalgun Prativadi, M.D.
Infectious Disease Physician in Monroeville, Pennsylvania. This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 8,292 in Infectious Disease Physician, and covers specialty classification, practice address, and Medicare Part D prescribing data when reported. According to CMS, every field reflects the provider's official federal registration, see our methodology.
What the federal data shows
Phalgun Prativadi, M.D. reported a CMS MIPS final score of 93.8/100 - above the 83.1 national average - and filed 202 Medicare Part D claims in 2023.
- 93.8/100
- MIPS score · +11 vs avg
- 202
- Part D claims, 2023
- Likely
- board-certified (heuristic)
Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) - no proprietary rating or editorial opinion is applied.
Phalgun Prativadi, M.D.'s MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
94 Top 29% higher than 71% of 477,587 scored providers
Each bar is a band; taller bars hold more scored providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
Source CMS Merit-based Incentive Payment System (MIPS) · 2023
Where Phalgun Prativadi, M.D. sits
This provider among infectious disease physician peers
Across the 2,276 infectious disease physician providers who report both Medicare Part D prescribing and a MIPS quality score, Phalgun Prativadi, M.D. writes more Part D claims than 31% of them and scores higher on MIPS quality than 73% - placing this provider in the lower-volume, high-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Part D claim volume vs MIPS quality, by specialty percentile
Each dot is one infectious disease physician peer from a representative sample of 60; the gold marker is Phalgun Prativadi, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
Phalgun Prativadi, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 2 hospital affiliations - signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).
What does the federal data show about Phalgun Prativadi, M.D.?
High performer (top quartile)Primary specialty
Medicare Part D claims
MIPS final score
Specialty distribution in Pennsylvania
How Infectious Disease Physician compares to other specialties among Pennsylvania providers
Largest specialties in Pennsylvania (% of in-state providers)
Infectious Disease Physician ranks #76 among Pennsylvania's specialties (0.2% of in-state providers)
Each bar is a specialty's share of the Pennsylvania provider total, by primary NUCC taxonomy. The highlighted bar is Infectious Disease Physician; the long tail of smaller specialties is omitted for legibility.
Medicare quality performance, MIPS
Phalgun Prativadi, M.D.'s 2023 MIPS final score plotted against the Infectious Disease Physician national average
- MIPS Final Score
- 93.8/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Infectious Disease Physician) - 93.8/100 vs national avg 83.1
Quality benchmarks
- National MIPS avg 2023 reporting year
- Quality dim CMS Quality category
- Specialty volume Infectious Disease Physician US NPIs
93.8/100 MIPS final score - 10.7 pts above the 83.1 national average
Quality, Cost, Promoting Interoperability, and Improvement Activities composite score for the 2023 performance year. Specialty: Infectious Disease Physician. Quality dim: 85.1.
The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).
Phalgun Prativadi, M.D. appears in the CMS NPPES registry as a Infectious Disease Physician provider holding M.D. credentials at 3824 NORTHERN PIKE STE 405, Monroeville, PA, 15146, with a listed phone of (412) 372-8750. NPI 1598920985 was issued on 07/24/2008. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what Prativadi most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.
Medicare Part D records for calendar year 2023 show 202 prescription claims written by this provider, covering 57 Medicare beneficiaries and totaling roughly $16K in drug spend. These figures capture only Medicare Part D, commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 93.8/100 for the 2023 performance year (Quality 85.1), compared with the national average of 83.1.
Infectious Disease Physician is a mid-sized specialty nationwide, with 8,292 enrolled providers across 54 states and an average of 816 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist, always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.
Practice Address
Provider Details
| NPI | 1598920985 |
|---|---|
| Specialty | Infectious Disease Physician |
| Credentials | M.D. |
| Gender | Male |
| NPI Issued | 07/24/2008 |
Verify this provider's license
PlainDoctor pulls this profile from the CMS NPPES public registry. Confirm Phalgun Prativadi, M.D.'s current license status, disciplinary history, and board certifications with the Pennsylvania State Board of Medicine in Pennsylvania before relying on this page for a clinical or care decision.
How we sourced this profile
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
Reporting: Alternative Payment Model
Hospital and facility affiliations
Facilities where Phalgun Prativadi, M.D. bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" - a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.
Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).
Industry payments received (2024) - CMS Open Payments transparency data
The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for Phalgun Prativadi, M.D.. Source: openpaymentsdata.cms.gov.
Total received
$29
Largest payer
ABBVIE INC.
Most common payment type
Food and Beverage
Industry payments are not necessarily indicators of bias, they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.
License & disciplinary context - Pennsylvania PA-BOM 2023 annual report
Aggregate state board data only, NOT a determination of any individual provider's status. The figures below describe statewide disciplinary activity across all ~45K Pennsylvania medical licensees in 2023 - they are NOT specific to Phalgun Prativadi, M.D.. To verify Phalgun Prativadi, M.D.'s current license status, search the PA-BOM public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.
PA-BOM publishes annual disciplinary statistics as part of public-record reporting under each state's Administrative Procedure Act. See the full breakdown by action type and year on the Pennsylvania disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
Prescribing Breakdown
- 30-Day Fills
- 226
- Total Day Supply
- 2,157
- Generic Drug Cost
- $14K
- Antibiotic Claims
- 188
Patient Demographics
- Average Patient Age
- 70.5 years
- Avg HCC Risk Score
- 3.40
- Gender Split
- 49% female / 51% male
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Phalgun Prativadi, M.D. prescribes most
Top Medicare Part D drugs by claim count, 2023
- Ceftriaxone
Ceftriaxone
63 claims
- Vancomycin Hcl
Vancomycin Hcl
52 claims
- Cefazolin Sodium
Cefazolin Sodium
27 claims
- Cefepime Hcl 21
Cefepime Hcl
21 claims
| Drug | Claims |
|---|---|
| Ceftriaxone Ceftriaxone Sodium | 63 |
| Vancomycin Hcl | 52 |
| Cefazolin Sodium | 27 |
| Cefepime Hcl | 21 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Infectious Disease Physician Overview
How Phalgun Prativadi, M.D. fits within the Infectious Disease Physician landscape nationally.
Phalgun Prativadi, M.D.'s 202 claims are below the specialty average of 816.
Nearby Infectious Disease Physician Providers in Pennsylvania
Other clinicians with the same primary specialty enrolled in Pennsylvania, drawn from the same CMS NPPES roster as Prativadi.
Compare Infectious Disease Physician nationally: see state-by-state distribution →
Before you book an appointment
Use this federal record as your verification checklist, not as a recommendation.
- Confirm the NPI record is current in the official CMS registry, providers update their own NPPES details, and moves can lag. Verify this NPI
- Check the active license and any disciplinary history with the Pennsylvania medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Infectious Disease Physician peer on Medicare volume and prescribing patterns. Compare providers
Medicare Part D and MIPS figures describe practice patterns in federal programs only, they are not quality ratings, and PlainDoctor does not rate, rank, or recommend providers.
Healthcare Guides
Learn more about finding, verifying, and understanding healthcare providers.
Explore Pennsylvania
Frequently Asked Questions
What is Phalgun Prativadi, M.D.'s specialty? ▼
How much does Phalgun Prativadi, M.D. prescribe under Medicare Part D? ▼
What is Phalgun Prativadi, M.D.'s Medicare quality score? ▼
Where is Phalgun Prativadi, M.D. located? ▼
What is Phalgun Prativadi, M.D.'s NPI number? ▼
How many Infectious Disease Physician providers are there in the US? ▼
What drugs does Phalgun Prativadi, M.D. prescribe most often? ▼
Does Phalgun Prativadi, M.D. accept Medicare? ▼
How can I verify Phalgun Prativadi, M.D.'s credentials? ▼
Data Sources
- Provider Directory
- CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
- Specialty Classification
- NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
- Prescribing Data
- CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
- Quality Performance
- CMS Merit-based Incentive Payment System (MIPS) - 2023 performance year.
- Limitations
- Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.
See our complete data methodology for details on how we collect and process government data.
Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).
Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology