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

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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