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

Q: 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.

Q: What is Praveen Datar's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Praveen Datar was last updated on July 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

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: November 01, 2026.

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

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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 St Louis, 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

Phone(417) 256-9111

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

Open in Google Maps ↗

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

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

Medicare enrollment records show Praveen Datar reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ozarks Medical Center

Same address

General Acute Care Hospital

1100 N KENTUCKY AVE
West Plains, MO 65775

Reassigned Medicare billing, Missouri enrollment
338 clinicians in this Medicare group

NPI 1831115641 (417) 256-9111

Mercy Clinic Pulmonology - St. Louis, LLC

153 mi

Pulmonary Disease

621 S NEW BALLAS RD, SUITE 228-A
Saint Louis, MO 63141

Reassigned Medicare billing, Missouri enrollment
26 clinicians in this Medicare group

NPI 1821137886 (314) 251-4966

Mercy Clinic Adult Critical Care, LLC

154 mi

Critical Care Medicine

621 S NEW BALLAS RD, SUITE 4006-B
Saint Louis, MO 63141

Reassigned Medicare billing, Missouri enrollment
77 clinicians in this Medicare group

NPI 1730119421 (314) 251-6486

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

34 services28 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

25 services14 patients

Test to measure expiratory airflow and volume 94010

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

22 services22 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

22 services12 patients

Irrigation and suction of lung airways to obtain cells using an endoscope 31624

This is a procedure where a thin, flexible tube called an endoscope is inserted through your mouth into the lungs. A small amount of saline is then introduced to wash the airways. The fluid, along with cells from the lung, is suctioned back for analysis.

19 services19 patients

Aspiration of initial secretion of lung airway using an endoscope 31645

This procedure involves using a thin, flexible tube called an endoscope to collect initial secretions from your lung airway. This helps doctors diagnose and treat respiratory conditions. It's a safe, minimally invasive procedure.

17 services17 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

15 services15 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

15 services15 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

11 services11 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 St Louis

Acute Care Hospitals · Saint Louis, MO

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260020

Location615 New Ballas RoadSaint Louis, MO 63141 · St. Louis County

Emergency services Birthing friendly

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

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 Interoperability

Improvement Activities

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.

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