| Dr Prasuna Gnana Dubagunta, MD | |
|
1805 Hennepin Ave N, Glencoe, MN 55336-1416 | |
| (320) 864-3121 | |
| (320) 864-7887 |
| Full Name | Dr Prasuna Gnana Dubagunta |
|---|---|
| Gender | Female |
| Speciality | Internal Medicine |
| Experience | 21 Years |
| Location | 1805 Hennepin Ave N, Glencoe, Minnesota |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376573014 | NPI | - | NPPES |
| 208812201 | Medicaid | TX | |
| 8CF471 | Other | TX | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 055401 (Georgia) | Secondary |
| 207R00000X | Internal Medicine | 64422 (Minnesota) | Primary |
| 207R00000X | Internal Medicine | N1617 (Texas) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Fairview Southdale Hospital | Edina, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Fairview Clinics | 7113830142 | 736 |
| Entity Name | Fairview Health Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013994359 PECOS PAC ID: 1951213057 Enrollment ID: O20031105000461 |
| Entity Name | Fairview Clinics |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346432218 PECOS PAC ID: 7113830142 Enrollment ID: O20031106000516 |
| Entity Name | Healtheast Woodwinds Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356309322 PECOS PAC ID: 9638082563 Enrollment ID: O20031107000110 |
| Entity Name | Healtheast Medical Research Institute |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639125503 PECOS PAC ID: 3971407636 Enrollment ID: O20031124000507 |
| Entity Name | Healtheast St John's Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447218482 PECOS PAC ID: 9234035742 Enrollment ID: O20031208000320 |
| Entity Name | Fairview Express Care |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053952606 PECOS PAC ID: 3375645179 Enrollment ID: O20081028000548 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Prasuna Gnana Dubagunta, MD 1805 Hennepin Ave N, Glencoe, MN 55336-1416 Ph: (320) 864-3121 | Dr Prasuna Gnana Dubagunta, MD 1805 Hennepin Ave N, Glencoe, MN 55336-1416 Ph: (320) 864-3121 |
Peter Thomas Smyth, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1805 Hennepin Ave N, Glencoe Regional Health Services, Glencoe, MN 55336 Phone: 320-864-3121 Fax: 320-864-7887 |