NPIMap

Individual provider Active NPI

Matthew Ryan Prater, M.D.

  • Diagnostic Radiology Physician
  • Columbia, TN
National Provider Identifier
1972867398
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD0000054482 Issued in TN
Practice address
1224 Trotwood Ave
Columbia, TN 38401-4802
Phone
(931) 381-1111
NPI assigned
Jun 29, 2012
Last updated
Aug 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X MD0000054482 TN Primary

Addresses

Primary practice location

1224 Trotwood Ave
Columbia, TN 38401-4802

Mailing address

6300 Tower Cir Apt 326
Franklin, TN 37067-1531
Phone (629) 333-8130

Other practice location 1

5421 Main St
Spring Hill, TN 37174-4410
Phone (615) 577-4057

Other identifiers 1

IdentifierTypeStateIssuer
T-2594OtherMSTEMPORARY STATE MEDICAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mprater@sratn.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20170726004044 TN Practitioner - Diagnostic Radiology 2860795085 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Mississippi School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Radiology Associates PLLCGroup PAC ID 7214913649, 41 clinicians
Spring Hill Imaging Center, LLCGroup PAC ID 3577666536, 16 clinicians

Practice addresses (Care Compare)

1224 Trotwood Ave
Columbia, TN 38401-4802
Phone (931) 381-1111

5421 Main St
Suite C
Spring Hill, TN 37174-4410
Phone (931) 486-3425

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.31 of 100Reported as group
Quality
94.63
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
91.58 of 100Reported as group
Quality
83.16
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000054482TNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spring Hill Imaging Center LLC Single Specialty CurrentSince Jul 1, 2018 Accepting new patients
Southern Radiology Associates, PLLC Single Specialty CurrentSince Jul 1, 2018 Accepting new patients
Vanderbilt University Single Specialty PastSince Jul 1, 2017 Accepting new patients
Tuhc Radiology Group LLC Single Specialty PastSince Jul 1, 2017 Accepting new patients

Locations

1224 Trotwood Ave
Columbia, TN 38401
Phone (931) 380-4072

Organizations & group practices 4

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 6

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": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1972867398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 TOWER CIR APT 326",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370671531",
            "telephone_number": "629-333-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 TROTWOOD AVE",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014802",
            "telephone_number": "931-381-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5421 Main St",
            "address_purpose": "LOCATION",
            "city": "Spring Hill",
            "state": "TN",
            "postal_code": "371744410",
            "country_code": "US",
            "telephone_number": "615-577-4057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRATER",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-29",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "MD0000054482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEMPORARY STATE MEDICAL LICENSE",
            "identifier": "T-2594",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mprater@sratn.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health information service provider",
            "address_1": "5421 Main St",
            "city": "Spring Hill",
            "state": "TN",
            "country_code": "US",
            "postal_code": "371744410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

Verify at the official NPI Registry.