Individual provider Active NPI

Prabakar Kumar Rao, MD

  • Retina Specialist (Ophthalmology) Physician
  • Saint Louis, MO
National Provider Identifier
1417959115
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
118703 Issued in MO
Practice address
4901 Forest Park Ave
Dept Ophthalmology, 6TH FL
Saint Louis, MO 63108-1495
Phone
(314) 362-3937
Fax
(314) 362-3725
NPI assigned
Aug 12, 2005
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) Physician 207WX0107X 118703 MO Primary

Addresses

Primary practice location

4901 Forest Park Ave
Dept Ophthalmology, 6TH FL
Saint Louis, MO 63108-1495

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 362-3937

Other identifiers 1

IdentifierTypeStateIssuer
204824817MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20070514000134 MO Practitioner - Ophthalmology 2264328368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Southern California Keck School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

4901 Forest Park Ave
FL 6
Saint Louis, MO 63108-1495
Phone (314) 362-3937

517 S Euclid Ave
University Eye Center
Saint Louis, MO 63110-1007
Phone (314) 362-3431

5201 Mid America PLZ
Suite 2500
Saint Louis, MO 63129-0002
Phone (314) 273-0020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
118703MOMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University Current Accepting new patients
Washington University CurrentSince Apr 2, 2007 Accepting new patients
Washington University CurrentSince Apr 2, 2007 Accepting new patients
Washington University Past Accepting new patients
Retina & Vitreous Consultants Inc Ophthalmology Past Accepting new patients
The Retina Institute LLC Ophthalmology Past Accepting new patients
Retina Consultants, LLC Retina Specialist PastSince May 1, 2011 Accepting new patients
Retinal Consultants of Arizona LTD Ophthalmology Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
Eyenet Triage, PLC Ophthalmology Past Accepting new patients

Locations

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

4901 Forest Park Ave
Fl 6
Saint Louis, MO 63108

4921 Parkview Pl
#12
Saint Louis, MO 63110

4921 Parkview Pl
Ste 12B
Saint Louis, MO 63110
Phone (314) 747-9889

517 S Euclid Ave
Saint Louis, MO 63110
Phone (314) 362-3431

660 S Euclid Ave
#8096
Saint Louis, MO 63110
Phone (314) 362-3935

660 S Euclid Ave
#C
Saint Louis, MO 63110

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 10

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

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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1417959115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-362-3937",
            "fax_number": "314-362-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 FOREST PARK AVE",
            "address_2": "DEPT OPHTHALMOLOGY, 6TH FL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081495",
            "telephone_number": "314-362-3937",
            "fax_number": "314-362-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAO",
        "first_name": "PRABAKAR",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2025-04-17",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MO",
            "license": "118703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204824817",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4901 Forest Park Ave",
            "address_2": "Dept Ophthalmology, 6th Fl",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631081495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.