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

Dr. Prasad Polisetty, MD

Individual provider Internal Medicine Physician · NPI 1376711291

Dr. Prasad Polisetty, MD is an Internal Medicine in Johnson City, Tennessee. Qualified in 2004, 22 years ago. Licensed in Michigan.

Years since qualifying
22
Licensed in
MI
In the registry since
2008
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

1735 W State Of Franklin Rd Ste 5
Johnson City, TN 37604-6586
Phone: (423) 646-1862
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 4301090287 (MI)

Record details

NPI number1376711291
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 13, 2008
Last updated in NPPESJanuary 15, 2026
Certification dateJanuary 15, 2026
Mailing addressPo Box 791825, Baltimore, MD 21279-1825

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Accepts Medicare assignment Not indicated

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