Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Prabhakorn Kitbhoka, MD

Individual provider Nephrology Physician · NPI 1679703045

Dr. Prabhakorn Kitbhoka, MD is a Nephrology in Mishawaka, Indiana. Qualified in 2005, 21 years ago. Practices with Northeast Georgia Diagnostic Associates and Clinic, LLC, a 81-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Georgia, Indiana and Oregon.

Years since qualifying
21
Licensed in
GA, IN, OR
In the registry since
2009
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

710 Park Pl
Mishawaka, IN 46545-3519
Phone: (574) 273-6787
Fax: (574) 968-7160
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 3500 McClure Bridge Rd, Duluth, GA 30096-3131 — (770) 476-3636
  • 3615 Nw Samaritan Dr Ste 203, Corvallis, OR 97330-3771 — (541) 768-6930

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X · Licence 96918 (GA)
Nephrology Physician Taxonomy 207RN0300X · Licence 01077845A (IN)
Nephrology Physician Taxonomy 207RN0300X · Licence MD211417 (OR)

Record details

NPI number1679703045
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 20, 2009
Last updated in NPPESDecember 16, 2024
Certification dateDecember 16, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEPHROLOGY
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Northeast Georgia Diagnostic Associates And Clinic, Llc — 81 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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