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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. JEFFERY PRATER MD
NPI 1063494854
Internal Medicine in Martin, KY

Active since November 17, 2005PECOS EnrolledAccepts Medicare Assignment
97.4/100
CMS Quality Rating
12579 MAIN ST STE 101, MARTIN, KY 41649(606) 285-0681(606) 285-9843 Get Directions Write a Review

NPPES record last updated: August 4, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jeffery Prater Md NPPES

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

DR. JEFFERY PRATER MD (NPI 1063494854) is an individual internal medicine provider in Martin, Kentucky, licensed in Kentucky (26516) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Hazard Arh Regional Medical Center, and is a graduate of University Of Louisville School Of Medicine (1986).

NPPES Registry Identity

NPI1063494854
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. JEFFERY PRATERCredential: MD
Location Address12579 MAIN ST STE 101Martin, KY 41649-7400
Mailing Address12579 Main St Ste 101Martin, KY 41649-7400 · (606) 285-0681 · Fax (606) 285-9843
Phone(606) 285-0681
Fax(606) 285-9843
Sole ProprietorNo
Medical School CMSUniversity Of Louisville School Of MedicineGraduated 1986
Enumeration DateNovember 17, 2005
Last NPPES UpdateAugust 4, 2026
NPPES CertifiedAugust 4, 2026
✔ NPI 1063494854 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in KY · 26516
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
12579 MAIN ST STE 101, Martin, KY 41649
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Other Identifiers 1

Medicaid64265168KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.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

Dr. Jeffery Prater 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 ID5799791919
PECOS Enrollment IDI20060227000056
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 13

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.

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.
382 services77 patients
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.
378 services84 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
154 services16 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.
104 services46 patients
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.
81 services16 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.
67 services18 patients

Hospital Affiliations CMS Care Compare 3

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

Hazard Arh Regional Medical Center

Acute Care Hospitals · Hazard, KY
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180029
Location100 Medical Center DriveHazard, KY 41701 · Perry County
Emergency services Birthing friendly

Arh Our Lady Of The Way

Critical Access Hospitals · Martin, KY
OwnershipVoluntary non-profit - Private
CMS Certification Number181305
Location11203 Main StreetMartin, KY 41649 · Floyd County
Emergency services

Mary Breckinridge Arh Hospital

Critical Access Hospitals · Hyden, KY
OwnershipVoluntary non-profit - Private
CMS Certification Number181316
Location130 Kate Ireland DriveHyden, KY 41749 · Leslie County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41649 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
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

97.4/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality76.55
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 11

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers13 claims35 services$4.88 avg. paid by Medicare
Irrigation syringe, bulb or piston, each A4322
DME-Medical/Surgical Supplies · category DA000N
1 supplier27 claims189 services$2.92 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
2 suppliers12 claims12 services$119.10 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
2 suppliers12 claims35 services$36.22 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
2 suppliers15 claims84 services$2.68 avg. paid by Medicare
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
2 suppliers37 claims353 services$7.55 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Jeffery Prater's NPI number?

The NPI number for Jeffery Prater is 1063494854. It was assigned to this individual provider in the NPPES registry on November 17, 2005.

Where is Jeffery Prater located?

Jeffery Prater practices at 12579 Main St Ste 101, Martin, KY 41649. The listed phone number is (606) 285-0681.

What is Jeffery Prater's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jeffery Prater enrolled in Medicare?

Yes. Jeffery Prater 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 Jeffery Prater accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and CareSource list Jeffery Prater 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 Jeffery Prater affiliated with any hospitals?

According to CMS data, Jeffery Prater is affiliated with Hazard Arh Regional Medical Center, Arh Our Lady Of The Way and Mary Breckinridge Arh Hospital.

When was this NPI record last updated?

The NPPES record for Jeffery Prater was last updated on August 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 days 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.