Ethan A Prairie, MD in Rio Rancho, NM - Medicare Family Medicine

Ethan A Prairie, MD is a medicare enrolled "Family Medicine" physician in Rio Rancho, New Mexico. His current practice location is 4005 High Resort Blvd Se, Rio Rancho, New Mexico. You can reach out to his office (for appointments etc.) via phone at (505) 462-6000.

Ethan A Prairie is licensed to practice in New Mexico (license number MD2023-0538) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1134749195.

Contact Information

	Ethan A Prairie, MD
	4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906
	(505) 462-6000
	Not Available

Map and Direction

Physician's Profile

Full Name	Ethan A Prairie
Gender	Male
Speciality	Family Medicine
Location	4005 High Resort Blvd Se, Rio Rancho, New Mexico
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1134749195
Provider Enumeration Date: 04/20/2020
Last Update Date: 12/29/2023

Medicare PECOS Information:

PECOS PAC ID: 3375965239
Enrollment ID: I20230823000494

Medical Identifiers

Medical identifiers for Ethan A Prairie such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1134749195	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	MD2023-0538 (New Mexico)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ethan A Prairie allows following entities to bill medicare on his behalf.

Entity Name	Presbyterian Healthcare Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1104802354 PECOS PAC ID: 9234041708 Enrollment ID: O20031103000603

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ethan A Prairie is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Ethan A Prairie, MD 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 Ph: (505) 462-6000	Ethan A Prairie, MD 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 Ph: (505) 462-6000

Reviews and Comments

Family Medicine Doctors in Rio Rancho, NM

Lana K Wagner, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 4100 High Resort Blvd Se, Pmg Rio Rancho High Resort 4100, Rio Rancho, NM 87124 Phone: 505-462-8520 Fax: 505-462-8510
Jasmine Valerie Gutierrez, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 4005 High Resort Blvd Se, Rio Rancho, NM 87124 Phone: 505-462-6000
Dr. Santiago Marinez Ayala, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2300 Grande Blvd Se, Suite A, Rio Rancho, NM 87124 Phone: 505-896-7100
Mrs. Christina Marie Hannah, PA Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 184 Unser Blvd Ne, Rio Rancho, NM 87124 Phone: 505-896-0928
Paul Afek, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3001 Broadmoor Blvd Ne, Rio Rancho, NM 87144 Phone: 505-994-7397
J. Dayton Voorhees, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 4005 High Resort Blvd Se, Pmg High Resort 4005, Rio Rancho, NM 87124 Phone: 505-462-6000 Fax: 505-462-6006

Ethan A Prairie, MD - Medicare Family Medicine in Rio Rancho, NM