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

Dr. Prakash Viswanathan, MD

Individual provider Internal Medicine Physician · NPI 1649428574

Dr. Prakash Viswanathan, MD is a Gastroenterology in Maple Grove, Minnesota. Qualified in 2005, 21 years ago. Practices with New York University, a 5,884-clinician group and accepts Medicare assignment. Licensed in Maine, Minnesota and New York.

Years since qualifying
21
Licensed in
ME, MN, NY
In the registry since
2008
Specialties on file
4
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

9855 Hospital Dr Ste 102B
Maple Grove, MN 55369-5021
Phone: (763) 581-5600
Fax: (763) 581-5601
Show map & directions

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

Specialties & licences

Gastroenterology Physician (primary) Taxonomy 207RG0100X · Licence MD23388 (ME)
Internal Medicine Physician Taxonomy 207R00000X · Licence 250191 (NY)
Gastroenterology Physician Taxonomy 207RG0100X · Licence 250191 (NY)
Gastroenterology Physician Taxonomy 207RG0100X · Licence 62460 (MN)

Record details

NPI number1649428574
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedSeptember 4, 2008
Last updated in NPPESJuly 21, 2022
Certification dateFebruary 29, 2020
Mailing address9855 Hospital Dr Ste 102b, Maple Grove, MN 55369-5021

Medicare enrollment

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

Medicare specialtyGASTROENTEROLOGY
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice New York University — 5884 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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