Individual provider Active NPI

Robert Stephen Pranger, MD

  • Family Medicine Physician
  • Waterloo, IA
National Provider Identifier
1972582856
Registry record updated Nov 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD34769 Issued in IA
Practice address
220 Southbrooke Dr
Waterloo, IA 50702-5802
Phone
(319) 236-7751
Fax
(319) 236-7753
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD34769 IA Primary

Addresses

Primary practice location

220 Southbrooke Dr
Waterloo, IA 50702-5802

Mailing address

220 Southbrooke Dr
Waterloo, IA 50702-5802
Phone (319) 236-7751

Other identifiers 3

IdentifierTypeStateIssuer
1972582856MedicaidIA
P01020603OtherIARRMEDICARE
272308584-02OtherIAUNITED HEALTHCARE

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031209001044 IA Practitioner - Family Practice 3274439336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fiat Family MedicineGroup PAC ID 9739448267, 2 clinicians

Practice addresses (Care Compare)

220 Southbrooke Dr
Waterloo, IA 50702-5802
Phone (319) 236-7751

Hospital & facility affiliations

  • Mercyone Waterloo Medical Center Hospital, Waterloo, IA, CCN 160067
  • Allen Hospital Hospital, Waterloo, IA, CCN 160110

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD34769IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd County Memorial Hospital Commission Single Specialty Past Accepting new patients
Covenant Medical Center Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: robert.pranger.1@16707.direct.athenahealth.com
  • Direct secure messaging: rpranger3935306@direct.trinity-health.org

Organizations & group practices 3

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 2

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510099200000",
    "number": "1972582856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 SOUTHBROOKE DR",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025802",
            "telephone_number": "319-236-7751",
            "fax_number": "319-236-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SOUTHBROOKE DR",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025802",
            "telephone_number": "319-236-7751",
            "fax_number": "319-236-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRANGER",
        "first_name": "ROBERT",
        "middle_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2017-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "MD34769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972582856",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMEDICARE",
            "identifier": "P01020603",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "272308584-02",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.