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

Dr. Prashant Kolar, MD

Individual provider Internal Medicine Physician · NPI 1114175312

Dr. Prashant Kolar, MD is a Nephrology in Mesa, Arizona. Qualified in 2005, 21 years ago. Practices with Banner Cancer Center Specialists LLC, a 338-clinician group and accepts Medicare assignment. Licensed in Arizona, Illinois and Missouri.

Years since qualifying
21
Licensed in
AZ, IL, MO
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

612 W Baseline Rd
Mesa, AZ 85210-6041
Phone: (480) 834-9039
Fax: (480) 964-7802
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X · Licence 50486 (AZ)
Internal Medicine Physician Taxonomy 207R00000X · Licence 1253054038 (IL)
Internal Medicine Physician Taxonomy 207R00000X · Licence 036-127849 (IL)
Nephrology Physician Taxonomy 207RN0300X · Licence 2012003456 (MO)

Record details

NPI number1114175312
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 3, 2008
Last updated in NPPESSeptember 2, 2015
Mailing address612 W Baseline Rd, Mesa, AZ 85210-6041

Medicare enrollment

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

Medicare specialtyNEPHROLOGY
Also practisesINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Banner Cancer Center Specialists Llc — 338 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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