PRAVEEN DATAR MD
NPI 1053734657
Internal Medicine - Pulmonary Disease in West Plains, MO

Active since February 03, 2014PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
1100 N KENTUCKY AVE, WEST PLAINS, MO 65775(417) 256-9111 Get Directions Write a Review

NPPES record last updated: July 26, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 26, 2024, Jul 2, 2020 (2 updates tracked since 2020).

About Praveen Datar Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRAVEEN DATAR MD (NPI 1053734657) is an individual pulmonary disease provider in West Plains, Missouri, licensed in Missouri (2020004210) and active in the NPI registry since February 2014. He is enrolled in Medicare PECOS, is affiliated with Mercy Hospital Jefferson, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1053734657
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NamePRAVEEN DATARCredential: MD
Location Address1100 N KENTUCKY AVEWest Plains, MO 65775-2029
Mailing AddressPo Box 1100West Plains, MO 65775-1100 · (417) 256-9111 · Fax (417) 257-5924
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateFebruary 3, 2014
Last NPPES UpdateJuly 26, 20242 updates tracked since enumeration
NPPES CertifiedJuly 26, 2024
NPI 1053734657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License Licensed in MO · 2020004210
Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

1100 N KENTUCKY AVE, West Plains, MO 65775

Secondary Practice Locations 2

Location 11400 US Highway 61Festus, MO 63028-4100 · Phone (636) 933-5411
Location 21390 US Highway 61 Ste N2300Festus, MO 63028-4137 · Phone (636) 543-2405

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Praveen Datar Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2062839897
PECOS Enrollment IDI20200825003075
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 15

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
213 services179 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
81 services31 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
73 services73 patients
Test to determine lung volumes using sensors 94726
This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.
65 services65 patients
Test to measure expiratory airflow and volume changes before and after medication administration 94060
This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.
58 services58 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
38 services38 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mercy Hospital Jefferson

Acute Care Hospitals · Festus, MO
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260023
Location1400 Us Highway 61Festus, MO 63028 · Jefferson County
Emergency services

Mercy Hospital South

Acute Care Hospitals · Saint Louis, MO
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260077
Location10010 Kennerly RoadSaint Louis, MO 63128 · St. Louis County
Emergency services

Parkland Health Center

Acute Care Hospitals · Farmington, MO
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260163
Location1101 W LibertyFarmington, MO 63640 · St. Francois County
Emergency services Birthing friendly

Washington County Memorial Hospital

Critical Access Hospitals · Potosi, MO
OwnershipGovernment - Local
CMS Certification Number261308
Location300 Health WayPotosi, MO 63664 · Washington County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65775 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$121.96 typical visit price
range $52.28 – $161.24
Typical copayment $30.49 (range $13.07 – $40.31)
Most-billed visit code 99204
Established Patient
$93.24 typical visit price
range $16.30 – $131.05
Typical copayment $23.31 (range $4.07 – $32.76)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability98
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 14

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
1 supplier11 claims11 services$106.15 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
1 supplier11 claims11 services$25.04 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
1 supplier14 claims75 services$2.99 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers48 claims48 services$19.06 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
2 suppliers47 claims47 services$856.87 avg. paid by Medicare
Humidifier, heated, used with positive airway pressure device E0562
DME-Other DME · category DE001N
1 supplier31 claims31 services$18.37 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Anesthetist, Certified Registered
1100 N KENTUCKY AVE
WEST PLAINS, MO 65775
Physician Assistant
1100 N KENTUCKY AVE
WEST PLAINS, MO 65775
Nurse Practitioner
1100 N KENTUCKY AVE
WEST PLAINS, MO 65775
Nurse Anesthetist, Certified Registered
1100 N KENTUCKY AVE
WEST PLAINS, MO 65775
Speech-Language Pathologist
1100 N KENTUCKY AVE
WEST PLAINS, MO 65775
Occupational Therapist
1100 N KENTUCKY AVE
WEST PLAINS, MO 65775
Occupational Therapy Assistant
1100 N KENTUCKY AVE
WEST PLAINS, MO 65775
Speech-Language Pathologist
1100 N KENTUCKY AVE
WEST PLAINS, MO 65775

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Praveen Datar's NPI number?

The NPI number for Praveen Datar is 1053734657. It was assigned to this individual provider in the NPPES registry on February 3, 2014.

Where is Praveen Datar located?

Praveen Datar practices at 1100 N Kentucky Ave, West Plains, MO 65775. The listed phone number is (417) 256-9111.

What is Praveen Datar's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Praveen Datar enrolled in Medicare?

Yes. Praveen Datar is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Praveen Datar accept?

Health plans from Anthem Blue Cross and Blue Shield, Arkansas Blue Cross and Blue Shield, Health Advantage, Octave and UnitedHealthcare list Praveen Datar as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Praveen Datar affiliated with any hospitals?

According to CMS data, Praveen Datar is affiliated with Mercy Hospital Jefferson, Mercy Hospital South, Parkland Health Center and Washington County Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Praveen Datar was last updated on July 26, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.