Individual provider Active NPI

Bryan Neale Prater, MD

  • Ophthalmology Physician
  • Maysville, KY
National Provider Identifier
1043375348
Registry record updated May 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
17402 Issued in KY
Practice address
1360 Medical Park Dr
Maysville, KY 41056-9621
Phone
(606) 759-5341
Fax
(606) 759-7393
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 17402 KY Primary

Addresses

Primary practice location

1360 Medical Park Dr
Maysville, KY 41056-9621

Mailing address

1360 Medical Park Dr
Maysville, KY 41056-9621
Phone (606) 759-5341

Other identifiers 5

IdentifierTypeStateIssuer
3600115400MedicaidKY
6417402200MedicaidKY
6592808700MedicaidKY
7432874100MedicaidKY
7490044000MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100621000134 KY Practitioner - Ophthalmology 1355246034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Kentucky College of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1360 Medical Park Dr
Maysville, KY 41056-9621
Phone (606) 759-5341

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecare Network LTD Ophthalmology CurrentSince Jun 1, 2002 Accepting new patients
Eyecare Network LTD Past Accepting new patients
Eyecare Network LTD Past Accepting new patients

Locations

1360 Medical Park Dr
Maysville, KY 41056
Phone (606) 759-5341

Interoperability endpoints

  • FHIR API: https://eyecarenetworkltd.ef.prod.fhir.ema-api.com/fhir/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274832000000",
    "number": "1043375348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 MEDICAL PARK DR",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410569621",
            "telephone_number": "606-759-5341",
            "fax_number": "606-759-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 MEDICAL PARK DR",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410569621",
            "telephone_number": "606-759-5341",
            "fax_number": "606-759-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATER",
        "first_name": "BRYAN",
        "middle_name": "NEALE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2010-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": "17402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3600115400",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6417402200",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6592808700",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7432874100",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7490044000",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maysville, KY

Sources for this page

Verify at the official NPI Registry.