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

Prasanna Kommu

Individual provider Physical Therapist · NPI 1861998734

Prasanna Kommu is a Physical Therapist in Private Practice in Revere, Massachusetts. Qualified in 2011, 15 years ago. Practices with Functional Pathways Preferred of Tennessee LLC, a 192-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
15
Licensed in
VA
In the registry since
2018
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Practice location Address checks out

185 Squire Rd
Revere, MA 02151-1234
Phone: (781) 284-0559
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2305212542 (VA)

Record details

NPI number1861998734
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 1, 2018
Last updated in NPPESAugust 14, 2025
Certification dateAugust 14, 2025
Mailing address30 Parkside Pl, Malden, MA 02148-7869

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Functional Pathways Preferred Of Tennessee Llc — 192 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Revere