Prachi Nene, MD
Gastroenterology · Burlingame
- Medicare standing
- Clear
- Enrolled, allowed to bill and order, not excluded
- Plans that list them
- 9
- 1 carrier
- Offices
- 2
Offices
2 locations · Sutter Bay Medical Foundation · 3,783 clinicians in this group
Looking this up.
Hospitals listed: Mills-Peninsula Medical Center. That is not proof they admit you there this week.
Plans that list them
9 plans · 1 carrier
A missing listing does not mean out of network. Directories change, and a listing does not cover every office. Call Dr. Nene’s office to confirm they take your plan. Ask about the office you use, its medical group, referrals and appointments.
| Alignment Health BreathEasy (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Clarity (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Harmony (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Heart & Diabetes (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Heart & Diabetes CalPlus (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | Alignment Health Plan | Listed | Sep 28, 2026 |
| Alignment Health Heart & Diabetes Choice (HMO C-SNP) | Alignment Health Plan | Listed | Sep 28, 2026 |
| Alignment Health Honor+ Plan (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health My Choice CalCare (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
California Medical Board record
Licence A154558 · Current
Licensed to practise in California · since 2018 · expires 2027-11-30 · Boston University School of Medicine.
No disciplinary actions, convictions, malpractice judgments or citations in this record.
Hospitals they work in
1 hospital
These rate the hospital, not this clinician. Most measures at most hospitals are no different from the national rate.
- Peninsula Medical CenterBurlingame, CAAcute Care Hospital · Voluntary non-profit - Private · Has an emergency department · Birthing-friendlyPart of Sutter Health, which runs 27 hospitals in 2 statesPatients rate it 4 of 5 · 78% would definitely recommend itOverall rating: 5 of 5 starsBetter than the national rate — Catheter Associated Urinary Tract Infections (ICU + select Wards): 0.139, Oct 2024 – Sep 2025Better than the national rate — Clostridium Difficile (C.Diff): 0.242, Oct 2024 – Sep 2025
See every measure and the patient survey for Peninsula Medical Center
Behind the star rating — Deaths: 2 better, 6 the same, 0 worse of 8 measures. Safety: 2 better, 5 the same, 0 worse of 7 measures. Readmissions: 0 better, 10 the same, 1 worse of 11 measures. The star rating is worked out from an earlier period than the measures below, so the two can disagree.
| Catheter Associated Urinary Tract Infections (ICU + select Wards)Infections | 0.139 | Better | Oct 2024 – Sep 2025 |
| Clostridium Difficile (C.Diff)Infections | 0.242 | Better | Oct 2024 – Sep 2025 |
| Abdominopelvic accidental puncture or laceration rateComplications and deaths | 1.21 (0.27 to 2.15) · 1,258 cases | No different | Jul 2022 – Jun 2024 |
| CMS Medicare PSI 90: Patient safety and adverse events compositeComplications and deaths | 0.81 (0.51 to 1.1) | No different | Jul 2022 – Jun 2024 |
| Death rate among surgical inpatients with serious treatable complicationsComplications and deaths | 155.44 (112.67 to 198.21) · 90 cases | No different | Jul 2022 – Jun 2024 |
| Death rate for CABG surgery patientsComplications and deaths | 2.5 · 32 cases | None | Jul 2022 – Jun 2025 |
| Death rate for COPD patientsComplications and deaths | 7.1 · 82 cases | None | Jul 2022 – Jun 2025 |
| Death rate for heart attack patientsComplications and deaths | 10 · 188 cases | None | Jul 2022 – Jun 2025 |
| Death rate for heart failure patientsComplications and deaths | 9 · 473 cases | None | Jul 2022 – Jun 2025 |
| Death rate for pneumonia patientsComplications and deaths | 14.8 · 342 cases | None | Jul 2022 – Jun 2025 |
| Death rate for stroke patientsComplications and deaths | 9.4 · 485 cases | None | Jul 2023 – Jun 2025 |
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateComplications and deaths | 2.9 · 3,730 cases | None | Jul 2024 – Jun 2025 |
| Iatrogenic pneumothorax rateComplications and deaths | 0.2 (0 to 0.4) · 6,904 cases | No different | Jul 2022 – Jun 2024 |
| In-hospital fall-associated fracture rateComplications and deaths | 0.21 (0.02 to 0.4) · 7,052 cases | No different | Jul 2022 – Jun 2024 |
| Perioperative pulmonary embolism or deep vein thrombosis rateComplications and deaths | 3.41 (1.43 to 5.39) · 1,695 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative acute kidney injury requiring dialysis rateComplications and deaths | 1.72 (0.17 to 3.28) · 665 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative hemorrhage or hematoma rateComplications and deaths | 2.11 (0.66 to 3.56) · 1,545 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative respiratory failure rateComplications and deaths | 7.1 (1.3 to 12.9) · 670 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative sepsis rateComplications and deaths | 5.96 (2.63 to 9.29) · 653 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative wound dehiscence rateComplications and deaths | 1.61 (0.15 to 3.08) · 418 cases | No different | Jul 2022 – Jun 2024 |
| Pressure ulcer rateComplications and deaths | 0.14 (0 to 0.78) · 5,539 cases | No different | Jul 2022 – Jun 2024 |
| Rate of complications for hip/knee replacement patientsComplications and deaths | 3.7 · 192 cases | None | Apr 2023 – Mar 2025 |
| Central Line Associated Bloodstream Infection (ICU + select Wards)Infections | 0.215 | No different | Oct 2024 – Sep 2025 |
| MRSA BacteremiaInfections | 0.263 | No different | Oct 2024 – Sep 2025 |
| SSI - Colon SurgeryInfections | 0.74 | No different | Oct 2024 – Sep 2025 |
| Acute Myocardial Infarction (AMI) 30-Day Readmission RateUnplanned return visits | 14.3 · 300 cases | None | Jul 2023 – Jun 2025 |
| Heart failure (HF) 30-Day Readmission RateUnplanned return visits | 19 · 702 cases | None | Jul 2023 – Jun 2025 |
| Hospital return days for heart attack patientsUnplanned return visits | 1.2 · 207 cases | None | Jul 2022 – Jun 2025 |
| Hospital return days for heart failure patientsUnplanned return visits | -13.6 · 531 cases | None | Jul 2022 – Jun 2025 |
| Hospital return days for pneumonia patientsUnplanned return visits | 24.3 · 343 cases | None | Jul 2022 – Jun 2025 |
| Pneumonia (PN) 30-Day Readmission RateUnplanned return visits | 18.1 · 449 cases | None | Jul 2023 – Jun 2025 |
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapyUnplanned return visits | 4.5 (2.8 to 7) · 85 cases | No different | Jan 2024 – Dec 2024 |
| Rate of inpatient admissions for patients receiving outpatient chemotherapyUnplanned return visits | 9.6 (6.7 to 13.7) · 85 cases | No different | Jan 2024 – Dec 2024 |
| Rate of readmission after hip/knee replacementUnplanned return visits | 5.7 · 189 cases | None | Jul 2023 – Jun 2025 |
| Rate of readmission for CABGUnplanned return visits | 11 · 45 cases | None | Jul 2023 – Jun 2025 |
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patientsUnplanned return visits | 20.6 · 117 cases | None | Jul 2023 – Jun 2025 |
| Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)Unplanned return visits | 13 (9.7 to 17.2) · 584 cases | No different | Jan 2022 – Dec 2024 |
| Ratio of unplanned hospital visits after hospital outpatient surgeryUnplanned return visits | 0.9 (0.7 to 1.2) · 764 cases | No different | Jan 2024 – Dec 2024 |
What patients said (523 patients answered, 27% of those asked)
| Cleanliness | 4 |
| Nurse communication | 4 |
| Doctor communication | 4 |
| Communication about medicines | 3 |
| Discharge information | 4 |
| Overall hospital rating | 4 |
| Quietness | 3 |
| Recommend hospital | 5 |
| Room was "always" clean | 76% |
| Nurses "always" communicated well | 81% |
| Doctors "always" communicated well | 80% |
| Staff "always" explained | 58% |
| Yes, staff "did" give patients this information | 89% |
| Yes, staff "did" give patients information about help after discharge | 87% |
| Doctors "always" explained things so they could understand | 74% |
| Doctors "always" listened carefully | 79% |
| Doctors "always" treated them with courtesy and respect | 87% |
| Patients who gave a rating of "9" or "10" (high) | 75% |
| Staff "always" explained new medications | 72% |
| Nurses "always" explained things so they could understand | 77% |
| Nurses "always" listened carefully | 79% |
| Nurses "always" treated them with courtesy and respect | 88% |
| "Always" quiet at night | 54% |
| "YES", patients would definitely recommend the hospital | 78% |
| Staff "always" explained possible side effects | 44% |
| Yes, staff "did" give patients information about possible symptoms | 90% |
Original Medicare doctor bills
$74,698
Medicare paid this office $74,698 for 247 people.
This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.
| Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 74 | $17,270 | $233 |
| Return visit (30+ min) | 74 | $14,504 | $117 |
| Initial hospital care with straightforward or low-level medical decision making at least 55 minutes | 77 | $8,525 | $109 |
| Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 50 | $4,930 | $91 |
| New patient visit (45+ min) | 32 | $4,434 | $139 |
See all 10 services
| Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 74 | $17,270 | $233 |
| Return visit (30+ min) | 74 | $14,504 | $117 |
| Initial hospital care with straightforward or low-level medical decision making at least 55 minutes | 77 | $8,525 | $109 |
| Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 50 | $4,930 | $91 |
| New patient visit (45+ min) | 32 | $4,434 | $139 |
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 44 | $4,133 | $68 |
| New patient visit (30+ min) | 39 | $3,403 | $87 |
| Diagnostic exam of large bowel using a flexible endoscope | 14 | $2,307 | $165 |
| Biopsy of large bowel using a flexible endoscope | 32 | $2,228 | $68 |
| Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 12 | $1,380 | $106 |
Procedures Medicare counted
| Colonoscopy | 86 | More than 76% of doctors who do this |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 76 | More than 71% of doctors who do this |
Who their Medicare patients are
247 Original Medicare patients in 2024. Average age 77 · Women 64% · Also on Medicaid 11% · Health risk score 1.36. At or below the middle of the specialty; the typical gastroenterology clinician is at 1.42.
Conditions among them: High blood pressure 75% · Coronary heart disease 30% · Chronic kidney disease 30% · Diabetes 28% · Atrial fibrillation 27% · Heart failure 24% · Cancer 20% · Depression 20% · COPD 16% · Stroke 11% · Dementia 7%.
The office billed $589,310, Medicare allowed $95,815 and paid $74,698; for 596 services of 32 kinds.
Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.
Year by year
| 2024 | 247 | 596 | 77 | 1.36 | $589,310 | $74,698 |
| 2023 | 184 | 358 | 75 | 1.41 | $339,408 | $42,144 |
| 2022 | 78 | 130 | 74 | 1.11 | $91,450 | $14,661 |
Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.
See the services billed each year
2023: 8 services
| Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 51 | $12,243 | $231 |
| Return visit (30+ min) | 52 | $7,152 | $102 |
| Initial hospital care with straightforward or low-level medical decision making at least 55 minutes | 34 | $3,909 | $112 |
| New patient visit (30+ min) | 39 | $3,631 | $93 |
| Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 24 | $2,154 | $90 |
| Biopsy of large bowel using a flexible endoscope | 28 | $1,970 | $68 |
| Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes | 14 | $937 | $41 |
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 11 | $912 | $70 |
2022: 3 services
| New patient visit (45+ min) | 27 | $4,083 | $151 |
| Return visit (30+ min) | 18 | $2,266 | $119 |
| Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 11 | $1,168 | $106 |
Drugs they prescribed that Part D paid
$40,751
Pharmacies billed $40,751 in 2024.
This is pharmacy cost, not the office bill, and not what patients paid.
Opioids were 0% of their Part D prescriptions (0 of 409) in 2024. At or below the middle of the specialty; the typical gastroenterology clinician is at 0%.
296 generic and 113 brand-name prescriptions · $40,751 in drug cost · 39 antibiotic prescriptions to 18 people.
Part D prescriptions only. The opioid rate is opioid prescriptions as a share of all this clinician's Part D prescriptions; surgeons and pain specialists run higher than others, so it is shown against the same specialty.
| Linzess | 16 | $12,103 | $756 |
| Sod Sulf-Potass Sulf-Mag Sulf | 103 | $6,976 | $68 |
| Pantoprazole | 66 | $1,318 | $20 |
| Omeprazole | 53 | $1,290 | $24 |
| Peg 3350-Electrolyte | 58 | $1,150 | $20 |
See all 8 drugs
| Linzess | 16 | $12,103 | $756 |
| Sod Sulf-Potass Sulf-Mag Sulf | 103 | $6,976 | $68 |
| Pantoprazole | 66 | $1,318 | $20 |
| Omeprazole | 53 | $1,290 | $24 |
| Peg 3350-Electrolyte | 58 | $1,150 | $20 |
| Famotidine | 13 | $453 | $35 |
| Metronidazole | 12 | $127 | $11 |
| Lactulose | 11 | $32 | $3 |
Year by year
| 2024 | 409 | 211 | 0% (0) | 28% | $40,751 |
| 2023 | 312 | 184 | 0% (0) | 28% | $25,203 |
| 2022 | 130 | 70 | 0% (0) | 52% | $46,761 |
| 2021 | 97 | 31 | 0% (0) | None | $13,648 |
| 2020 | 100 | 31 | 0% (0) | 15% | $32,809 |
| 2019 | 226 | 46 | None | None | $31,475 |
| 2018 | 108 | 27 | None | None | $9,524 |
Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.
See the drugs prescribed each year
2023: 5 drugs
| Sod Sulf-Potass Sulf-Mag Sulf | 87 | $6,549 | $75 |
| Pantoprazole | 56 | $1,037 | $19 |
| Peg 3350-Electrolyte | 28 | $641 | $23 |
| Omeprazole | 27 | $473 | $18 |
| Famotidine | 16 | $295 | $18 |
2022: 5 drugs
| Vemlidy | 20 | $27,935 | $1,397 |
| Mesalamine Dr | 12 | $5,589 | $466 |
| Sod Sulf-Potass Sulf-Mag Sulf | 21 | $1,679 | $80 |
| Suprep | 14 | $1,567 | $112 |
| Omeprazole | 15 | $236 | $16 |
2021: 2 drugs
| Entecavir | 22 | $4,061 | $185 |
| Pantoprazole | 14 | $331 | $24 |
2020: 1 drug
| Entecavir | 14 | $8,198 | $586 |
2019: 5 drugs
| Atorvastatin | 42 | $572 | $14 |
| Metformin | 15 | $123 | $8 |
| Benazepril | 14 | $113 | $8 |
| Omeprazole | 15 | $105 | $7 |
| Amlodipine Besylate | 14 | $104 | $7 |
Money from drug and device companies
$358 in 2025
| 2025 | 4 | 17 | None | $358 |
| 2024 | 8 | 19 | None | $429 |
| 2023 | 8 | 27 | None | $631 |
| 2022 | 3 | 6 | None | $249 |
| 2021 | 1 | 1 | None | $12 |
Paid work is consulting, speaking, honoraria and royalties, as opposed to meals and travel.
A payment is not proof that care is biased.
| Abbvie | Creon | $231 | 13 payments
|
| Aimmune Therapeutics | Zenpep | $75 | 2 payments
|
| Phathom Pharmaceuticals | Voquezna | $28 | 1 payment
|
| Salix Pharmaceuticals a division of Bausch Health US | Xifaxan | $24 | 1 payment
|
See all 17 published payments
| Abbvie | Meals · 2025-12-01 | Creon | $29 |
| Abbvie | Meals · 2025-11-19 | Skyrizi | $26 |
| Abbvie | Meals · 2025-10-28 | Skyrizi | $6 |
| Abbvie | Meals · 2025-10-20 | Skyrizi | $24 |
| Abbvie | Meals · 2025-10-20 | Creon | $7 |
| Salix Pharmaceuticals a division of Bausch Health US | Meals · 2025-10-20 | Xifaxan | $24 |
| Aimmune Therapeutics | Meals · 2025-09-09 | Zenpep | $34 |
| Abbvie | Meals · 2025-09-04 | Creon | $30 |
| Aimmune Therapeutics | Meals · 2025-05-01 | Zenpep | $41 |
| Abbvie | Meals · 2025-04-25 | Creon | $25 |
| Abbvie | Meals · 2025-04-22 | Creon | $9 |
| Abbvie | Meals · 2025-04-17 | Rinvoq | $21 |
| Abbvie | Meals · 2025-04-08 | Creon | $6 |
| Abbvie | Meals · 2025-03-19 | Skyrizi | $17 |
| Abbvie | Meals · 2025-03-05 | Rinvoq | $3 |
| Abbvie | Meals · 2025-02-06 | Rinvoq | $29 |
| Phathom Pharmaceuticals | Meals · 2025-01-30 | Voquezna | $28 |
See earlier years (2024, 2023, 2022, 2021)
2024: $429
| Abbvie | Rinvoq | $178 | 8 payments
|
| Lilly USA | Omvoh | $63 | 2 payments
|
| Pfizer | Xeljanz | $45 | 2 payments
|
| Celltrion USA | Vegzelma | $42 | 2 payments
|
| QOL Medical | Sucraid | $40 | 2 payments
|
| Salix Pharmaceuticals a division of Bausch Health US | Xifaxan | $25 | 1 payment
|
| Phathom Pharmaceuticals | Voquezna | $19 | 1 payment
|
| Aimmune Therapeutics | Zenpep | $17 | 1 payment
|
2023: $631
| Abbvie | Rinvoq | $303 | 11 payments
|
| Janssen Biotech | Stelara | $89 | 4 payments
|
| QOL Medical | Sucraid | $58 | 3 payments
|
| Takeda Pharmaceuticals U.S.A. | Entyvio | $52 | 3 payments
|
| Merck Sharp & Dohme | Dificid | $45 | 2 payments
|
| Boston Scientific | None | $37 | 2 payments
|
| Nestle Healthcare Nutrition | Zenpep | $29 | 1 payment
|
| Pfizer | Xeljanz | $19 | 1 payment
|
2022: $249
| Regeneron Pharmaceuticals | Dupixent | $125 | 1 payment
|
| Abbvie | Skyrizi | $75 | 3 payments
|
| Janssen Biotech | Stelara | $49 | 2 payments
|
2021: $12
| Boston Scientific | General Metal Stents G I | $12 | 1 payment
|
Professional record
- NPI
- 1124481619
- Licence
- CA A154558California A154558: Current · expires 2027-11-30
- Video visits
- Lists video visits
- Gender
- Female
More record details
- Sole proprietor
- No
- Medicaid ID
- CA PN3232267556
- Taxonomy
- Federal specialty code 207RG0100X (207RG0100X); Student in a training program (390200000X)
- Mailing address
- 325 Distel Cir, Los Altos, CA, 94022
- NPI first listed
- 2016-04-01
- NPI last updated
- 2022-07-15
- NPI record certified
- 2022-07-15
This is when the NPI record was last certified, not a medical board exam.