Andra L Prum, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1123 Issued in NV

Practice address

8905 W Post Rd Ste 110
Las Vegas, NV 89148-2429

Phone

(702) 660-2024

Fax

(701) 203-9648

NPI assigned

Jan 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Family Practice

Education

College of Osteo Med of the Pacific at Pomona, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aprum119702@westdirect.optum.com

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.

• Prum Healthcare LTD

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1730075045
  Medicare reassignment NPD Authorized official
• Las Vegas Medical Group LLC

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1447656988

  Family Medicine

  Medicare reassignment NPD
• Optum Medical Group II Rhodes P C

  dba Southwest Medical

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1790329407
  Medicare reassignment NPD
• Optum Medical Group Rhodes P C

  dba Optumcare Anesthesia

  • Anesthesiology Physician
  • Las Vegas, NV
  • NPI 1770556037
  NPD
• Southwest Medical Associates Inc.

  • Ambulatory Surgical Clinic/Center
  • Las Vegas, NV
  • NPI 1174607303
  NPD (past)

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1326026824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11700 W CHARLESTON BLVD # 170-597",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891351573",
            "telephone_number": "702-660-2024",
            "fax_number": "701-203-9648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8905 W POST RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891482429",
            "telephone_number": "702-660-2024",
            "fax_number": "701-203-9648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4750 W Oakey Blvd Ste 4A",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891021535",
            "country_code": "US",
            "telephone_number": "702-877-5199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUM",
        "first_name": "ANDRA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-04",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "1123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY/CDS",
            "identifier": "CS11196",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jelani Pruitt
• Miah K Pruitt
• Molly C Pruitt, FNP
• Ross Leon Prujan, M.D.
• Prum Healthcare LTD
• Erica Prusak
• Nebojsa Prvulov, BSC,LMT,MMT,CNC,HT.
• Alexis Pryor
• Colin Michael Pryor, MSW, LCADC, LCSW
• Jade Pryor, RBT

• Family Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; 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.