NPIMap

Individual provider Active NPI

Fiona R. Prabhu, M.D.

  • Family Medicine Physician
  • Lubbock, TX
National Provider Identifier
1770575730
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K0545 Issued in TX
Practice address
3601 4TH St
Suite 1C143
Lubbock, TX 79430-8143
Phone
(806) 743-2757
Fax
(806) 743-2563
NPI assigned
Aug 16, 2005
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas a & M University System, HSC, College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Tech University Health Sciences Center Lubbock 363 clinicians

Practice addresses (Care Compare)

3601 4TH St
Lubbock, TX 79430-9436
Phone (806) 743-2475

Hospital & facility affiliations

  • University Medical Center Hospital, Lubbock, TX, CCN 450686
  • Covenant Medical Center Hospital, Lubbock, TX, CCN 450040

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
87.98
Promoting interoperability
100
Improvement activities
40

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060508000609 TX Practitioner - Family Practice 2668483439 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K0545TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock Family Medicine CurrentSince Oct 15, 1996 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Oct 15, 1996 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients
Covenant Medical Center Past Accepting new patients

Locations

3601 4th St
Ste 1C143
Lubbock, TX 79430
Phone (806) 743-2757

4000 24th St
#410
Lubbock, TX 79410
Phone (806) 743-7700

3601 4th St
Fl 1
Lubbock, TX 79430
Phone (806) 743-2757

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

Interoperability endpoints

  • Direct secure messaging: fiona.prabhu@direct.myteamcare.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K0545 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

3601 4TH St
Suite 1C143
Lubbock, TX 79430-8143

Mailing address

PO Box 5865
Lubbock, TX 79408-5865
Phone (806) 743-2898

Other identifiers 11

NPPES NPI Registry
IdentifierTypeStateIssuer
121753103MedicaidTX
124998903MedicaidTX
121753100OtherTXFIRSTCARE COMMERCIAL
82830ZOtherTXHMO BLUE
124998901MedicaidTX
87811GOtherTXBCBS
A002OtherNMTRIWEST
P3642MedicaidNM
86797OtherNMPRESBYTERIAN COMMERCIAL
86797MedicaidNM
100008000AMedicaidOK

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address ttufamilymedicine@direct.myteamcare.com Direct

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 10, 2020.

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1770575730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5865",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794085865",
            "telephone_number": "806-743-2898",
            "fax_number": "806-743-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "address_2": "SUITE 1C143",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794308143",
            "telephone_number": "806-743-2757",
            "fax_number": "806-743-2563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRABHU",
        "first_name": "FIONA",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K0545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121753103",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124998903",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE COMMERCIAL",
            "identifier": "121753100",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO BLUE",
            "identifier": "82830Z",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124998901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "87811G",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIWEST",
            "identifier": "A002",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P3642",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN COMMERCIAL",
            "identifier": "86797",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "86797",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100008000A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ttufamilymedicine@direct.myteamcare.com",
            "affiliation": "N",
            "endpointDescription": "TTUHSC Family Medicine",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3601 4th St",
            "address_2": "Suite 1C143",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794308143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.