Individual provider Active NPI

Prathima Moorthy, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Naples, FL
National Provider Identifier
1164537973
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
ME056744 Issued in FL
Practice address
4760 Tamiami Trail North
Suite 27
Naples, FL 34109-3884
Phone
(239) 593-9594
Fax
(239) 593-4099
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X ME056744 FL Primary

Addresses

Primary practice location

4760 Tamiami Trail North
Suite 27
Naples, FL 34109-3884

Mailing address

4760 Tamiami Trail N
Suite 27
Naples, FL 34103
Phone (239) 593-9594

Other identifiers 1

IdentifierTypeStateIssuer
ME056744OtherFLMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070214000165 FL Practitioner - Interventional Pain ManagementPractitioner - Physical Medicine and Rehabilitation 0042235046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
University of Wisconsin School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pain Management Center of Naples LLCGroup PAC ID 3971779711, 2 clinicians

Practice addresses (Care Compare)

4760 Tamiami TRL N
Suite 27
Naples, FL 34103-3057
Phone (239) 593-9599

Hospital & facility affiliations

  • Naples Community Hospital Hospital, Naples, FL, CCN 100018

Merit-based Incentive Payment System (MIPS)

Final score
72.27 of 100Reported as individual
Quality
76.69
Promoting interoperability
44
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME056744FLMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Management Center of Naples LLC Pain Medicine CurrentSince Sep 1, 2006 Accepting new patients
Kan Anesthesia,LLC PastSince Jan 5, 2015 Accepting new patients
Aln Anesthesia, P.a. Past Accepting new patients

Locations

3439 Pine Ridge Rd
Ste 301
Naples, FL 34109
Phone (239) 591-4582

4760 Tamiami Trl N
Ste 27
Naples, FL 34103
Phone (239) 593-9594

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1164537973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 TAMIAMI TRAIL N",
            "address_2": "SUITE 27",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "34103",
            "telephone_number": "239-593-9594",
            "fax_number": "239-593-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 TAMIAMI TRAIL NORTH",
            "address_2": "SUITE 27",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341093884",
            "telephone_number": "239-593-9594",
            "fax_number": "239-593-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORTHY",
        "first_name": "PRATHIMA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "FL",
            "license": "ME056744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME056744",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.