Kevin J. Prater, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001453 Issued in IA

Practice address

105 Valley West Dr
Suite 100
West Des Moines, IA 50265-3902

Phone

(515) 223-4368

Fax

(515) 453-2368

NPI assigned

Nov 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of Nebraska College of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iowa ENT Center PLLCGroup PAC ID 6406007608, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Greater Regional Medical Center Hospital, Creston, IA, CCN 161365
• Pella Regional Health Center Hospital, Pella, IA, CCN 161367

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kprater777430@direct.unitypoint.org

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.

• Greater Regional Medical Center

  • Critical Access Hospital
  • Creston, IA
  • NPI 1902805062
  Medicare reassignment NPD
• Iowa ENT Center PLLC

  • Otolaryngology Physician
  • West Des Moines, IA
  • NPI 1528314960
  Care Compare group
• Greater Regional Medical Center

  • Rural Health Clinic/Center
  • Greenfield, IA
  • NPI 1194406223

  Physician Assistant

  NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Boone County Hospital

  • Critical Access Hospital
  • Boone, IA
  • NPI 1467434225
  NPD (past)
• ENT Clinic of Iowa, PC

  • Otolaryngology Physician
  • West Des Moines, IA
  • NPI 1033162706
  NPD (past)

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

• Greater Regional Medical Center

  • Critical Access Hospital
  • Creston, IA
  • NPI 1902805062
  Care Compare affiliation
• Pella Regional Health Center

  • Critical Access Hospital
  • Pella, IA
  • NPI 1578520888
  Care Compare affiliation

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1194706176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 VALLEY WEST DR",
            "address_2": "SUITE 100",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502653902",
            "telephone_number": "515-223-4368",
            "fax_number": "515-453-2368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 VALLEY WEST DR",
            "address_2": "SUITE 100",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502653902",
            "telephone_number": "515-223-4368",
            "fax_number": "515-453-2368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATER",
        "first_name": "KEVIN",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001453",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IA",
            "license": "001453",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IB2608010",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IB2878003",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IB2610005",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IB2609013",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kara Powell, DPT
• Kelli Powell
• Ruth Alice Powell
• Tiaira Powell, LMT
• Praveen Chandra Prasad, MD
• Makaela Marie Pratt, LISW
• Sydney Loraine Pratt
• Precious Care Ia LLC
• Precision Psychiatry LLC
• Premier Counseling Professionals, LLC

• Physician Assistant in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.