Raymond William Pryor III, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036124770 Issued in IL

Practice address

3601 SW 160TH Ave
Suite #250
Miramar, FL 33027-6308

Phone

(954) 399-4642

Fax

(877) 859-8768

NPI assigned

Jan 5, 2010

Last updated

Jun 29, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

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 PracticeAlso: Peripheral Vascular Disease

Education

Southern Illinois University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore Wound Center, LTDGroup PAC ID 7012299597, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kindred Hospital - Chicago Long-term care hospital, Northlake, IL, CCN 142008

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2474/brand/3/csg/81/fhir/r4

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.

• North Shore Wound Center, LTD

  • Medical Specialty Clinic/Center
  • Skokie, IL
  • NPI 1023550811
  Medicare reassignment Care Compare group NPD
• Vohra Wound Physicians of Il, S.C.

  • Family Medicine Physician
  • Arlington Heights, IL
  • NPI 1790080505
  Medicare reassignment NPD

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

• Kindred Chicago Northlake, LLC

  dba Kindred Hospital - Chicago (Northlake Campus)

  • Long Term Care Hospital
  • Northlake, IL
  • NPI 1508472804

  Long-term care hospital

  Care Compare affiliation
• Kindred Chicago Northlake, LLC

  dba Kindred Hospital - Chicago (North Campus)

  • Long Term Care Hospital
  • Chicago, IL
  • NPI 1821604125

  Long-term care hospital

  Care Compare affiliation

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

{
    "created_epoch": "1262649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309305600000",
    "number": "1447580022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 SW 160TH AVE",
            "address_2": "SUITE #250",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276308",
            "telephone_number": "954-399-4642",
            "fax_number": "877-859-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 SW 160TH AVE",
            "address_2": "SUITE #250",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276308",
            "telephone_number": "954-399-4642",
            "fax_number": "877-859-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRYOR",
        "first_name": "RAYMOND",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-05",
        "last_updated": "2011-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036124770",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036124770",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036124770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00847866",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036124770",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa R Prophete
• Arniauld Prophete
• Providers Who Care Alf LLC
• Ann-Marie Elizabeth Pryce, ARNP
• Clare V Pryce, ARNP
• Psychsource
• Publix Super Markets Inc (Publix Pharmacy #0673)
• Publix Super Markets Inc (Publix Pharmacy #0674)
• Publix Super Markets Inc (Publix Pharmacy #0368)
• Publix Super Markets Inc (Publix Pharmacy #0652)

• Family Medicine Physician in Miramar, FL
• Providers in Miramar, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; 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.