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

Pratyusha Tantravahi, DO

Individual provider Family Medicine Physician · NPI 1295198414

Pratyusha Tantravahi, DO is a Family Practice in Fort Wayne, Indiana. Qualified in 2016, 10 years ago. Practices with Parkview Health System Inc, a 1,336-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Indiana and North Dakota.

Years since qualifying
10
Licensed in
IN, ND
In the registry since
2016
Specialties on file
4
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone: (260) 266-2020
Fax: (260) 266-2009
Show map & directions

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

Additional practice locations (1)

  • 501 Madison Ave, Scranton, PA 18510-2401 — (570) 343-2383

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 02006015A (IN)
Family Medicine Physician Taxonomy 207Q00000X · Licence 02006015 (IN)
Family Medicine Physician Taxonomy 207Q00000X · Licence 15769 (ND)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1295198414
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorYes
NPI enumeratedApril 4, 2016
Last updated in NPPESOctober 14, 2022
Certification dateOctober 14, 2022
Mailing address11109 Parkview Plaza Dr, Mailbox 117, Fort Wayne, IN 46845

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Parkview Health System Inc — 1336 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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