DR. WHITNEY M. PRATT MD
NPI 1083849335
Physical Medicine & Rehabilitation in Indianapolis, IN

Medicare Participation & PECOS Enrollment Status

Whitney Pratt is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Whitney Pratt is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

• Is the provider registered in PECOS? Yes

• PECOS PAC ID: 3678712254

  What is the PECOS Associate Control ID?
  A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

• PECOS Enrollment ID: I20130828000735

  What is the Provider Enrollment ID?
  The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

• Accepts Medicare Assignment? Yes

  What does it mean "accepts medicare assignment"?
  When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
  A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

• Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

• Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

• Eligible to Order or Refer a Home Health Agency (HHA): Yes

• Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

• DME-Hospital Beds (DB000N)

  Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)

  4 DME suppliers used 33 Medicare Claims 33 Services Paid

• DME-Other DME (DE000N)

  Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) (HCPCS:E0630)

  5 DME suppliers used 23 Medicare Claims 23 Services Paid

• DME-Other DME (DE000N)

  Patient lift, electric with seat or sling (HCPCS:E0635)

  2 DME suppliers used 28 Medicare Claims 28 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each (HCPCS:E0953)

  2 DME suppliers used 13 Medicare Claims 26 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each (HCPCS:E0955)

  3 DME suppliers used 18 Medicare Claims 18 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each (HCPCS:E0956)

  2 DME suppliers used 15 Medicare Claims 30 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware (HCPCS:E0960)

  3 DME suppliers used 18 Medicare Claims 18 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction (HCPCS:E1007)

  3 DME suppliers used 16 Medicare Claims 16 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each (HCPCS:E1012)

  4 DME suppliers used 17 Medicare Claims 17 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory (HCPCS:E1028)

  4 DME suppliers used 34 Medicare Claims 100 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair accessory, ventilator tray, fixed (HCPCS:E1029)

  1 DME suppliers used 22 Medicare Claims 22 Services Paid

• DME-Wheelchairs (DD000N)

  Manual adult size wheelchair, includes tilt in space (HCPCS:E1161)

  1 DME suppliers used 11 Medicare Claims 11 Services Paid

• DME-Wheelchairs (DD000N)

  Wheelchair, pediatric size, folding, adjustable, without seating system (HCPCS:E1238)

  1 DME suppliers used 12 Medicare Claims 12 Services Paid

• DME-Wheelchairs (DD009N)

  Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware (HCPCS:E2311)

  3 DME suppliers used 16 Medicare Claims 16 Services Paid

• DME-Wheelchairs (DD009N)

  Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each (HCPCS:E2313)

  3 DME suppliers used 16 Medicare Claims 16 Services Paid

• DME-Wheelchairs (DD009N)

  Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated (HCPCS:E2323)

  2 DME suppliers used 12 Medicare Claims 12 Services Paid

• DME-Wheelchairs (DD009N)

  Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) (HCPCS:E2363)

  2 DME suppliers used 11 Medicare Claims 22 Services Paid

• DME-Wheelchairs (DD009N)

  Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue (HCPCS:E2377)

  3 DME suppliers used 16 Medicare Claims 16 Services Paid

• DME-Wheelchairs (DD021N)

  Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware (HCPCS:E2620)

  2 DME suppliers used 19 Medicare Claims 19 Services Paid

• DME-Wheelchairs (DD021N)

  Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth (HCPCS:E2622)

  3 DME suppliers used 17 Medicare Claims 17 Services Paid

• DME-Wheelchairs (DD021N)

  Wheelchair component or accessory, not otherwise specified (HCPCS:K0108)

  5 DME suppliers used 32 Medicare Claims 86 Services Paid

• DME-Other DME (DE000N)

  Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes (HCPCS:K0739)

  6 DME suppliers used 41 Medicare Claims 221 Services Paid

• DME-Wheelchairs (DD009N)

  Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds (HCPCS:K0861)

  3 DME suppliers used 15 Medicare Claims 15 Services Paid

Orthotic Devices

• DME-Orthotic Devices (DF003N)

  Below knee, molded socket, shin, sach foot, endoskeletal system (HCPCS:L5301)

  8 DME suppliers used 14 Medicare Claims 15 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, test socket, below knee (HCPCS:L5620)

  11 DME suppliers used 24 Medicare Claims 47 Services Paid

• DME-Orthotic Devices (DF000N)

  Addition to lower extremity, test socket, above knee (HCPCS:L5624)

  9 DME suppliers used 14 Medicare Claims 25 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee, acrylic socket (HCPCS:L5629)

  11 DME suppliers used 29 Medicare Claims 30 Services Paid

• DME-Orthotic Devices (DF000N)

  Addition to lower extremity, above knee or knee disarticulation, acrylic socket (HCPCS:L5631)

  8 DME suppliers used 12 Medicare Claims 13 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee, total contact (HCPCS:L5637)

  13 DME suppliers used 33 Medicare Claims 34 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee, flexible inner socket, external frame (HCPCS:L5645)

  10 DME suppliers used 21 Medicare Claims 22 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee suction socket (HCPCS:L5647)

  8 DME suppliers used 21 Medicare Claims 21 Services Paid

• DME-Orthotic Devices (DF000N)

  Addition to lower extremity, ischial containment/narrow m-l socket (HCPCS:L5649)

  9 DME suppliers used 15 Medicare Claims 16 Services Paid

• DME-Orthotic Devices (DF000N)

  Additions to lower extremity, total contact, above knee or knee disarticulation socket (HCPCS:L5650)

  9 DME suppliers used 15 Medicare Claims 16 Services Paid

• DME-Orthotic Devices (DF000N)

  Addition to lower extremity, above knee, flexible inner socket, external frame (HCPCS:L5651)

  8 DME suppliers used 14 Medicare Claims 15 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert (HCPCS:L5671)

  15 DME suppliers used 22 Medicare Claims 25 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism (HCPCS:L5673)

  17 DME suppliers used 26 Medicare Claims 58 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism (HCPCS:L5679)

  8 DME suppliers used 30 Medicare Claims 60 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each (HCPCS:L5685)

  10 DME suppliers used 30 Medicare Claims 59 Services Paid

• DME-Orthotic Devices (DF003N)

  Replacement, socket, below knee, molded to patient model (HCPCS:L5700)

  8 DME suppliers used 16 Medicare Claims 16 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition, endoskeletal system, below knee, alignable system (HCPCS:L5910)

  13 DME suppliers used 26 Medicare Claims 27 Services Paid

• DME-Orthotic Devices (DF000N)

  Addition, endoskeletal system, above knee or hip disarticulation, alignable system (HCPCS:L5920)

  9 DME suppliers used 12 Medicare Claims 13 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) (HCPCS:L5940)

  11 DME suppliers used 29 Medicare Claims 30 Services Paid

• DME-Orthotic Devices (DF000N)

  Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal) (HCPCS:L5950)

  8 DME suppliers used 12 Medicare Claims 13 Services Paid

• DME-Orthotic Devices (DF003N)

  All lower extremity prostheses, flex-walk system or equal (HCPCS:L5981)

  8 DME suppliers used 14 Medicare Claims 16 Services Paid

• DME-Orthotic Devices (DF003N)

  Prosthetic sock, multiple ply, below knee, each (HCPCS:L8420)

  15 DME suppliers used 36 Medicare Claims 331 Services Paid

• DME-Orthotic Devices (DF000N)

  Prosthetic sock, multiple ply, above knee, each (HCPCS:L8430)

  9 DME suppliers used 17 Medicare Claims 156 Services Paid

• DME-Orthotic Devices (DF000N)

  Prosthetic shrinker, below knee, each (HCPCS:L8440)

  9 DME suppliers used 17 Medicare Claims 52 Services Paid

• DME-Orthotic Devices (DF000N)

  Prosthetic shrinker, above knee, each (HCPCS:L8460)

  7 DME suppliers used 11 Medicare Claims 32 Services Paid

• DME-Orthotic Devices (DF000N)

  Prosthetic sock, single ply, fitting, below knee, each (HCPCS:L8470)

  12 DME suppliers used 29 Medicare Claims 227 Services Paid

• DME-Orthotic Devices (DF000N)

  Prosthetic sock, single ply, fitting, above knee, each (HCPCS:L8480)

  7 DME suppliers used 14 Medicare Claims 129 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 43 times for 33 patients

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 185 times for 128 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 23 times for 23 patients

Evaluation for wheelchair, each 15 minutes

This procedure involves assessing your physical needs and capabilities to determine the most suitable wheelchair for you. It takes into account your comfort, mobility, and lifestyle requirements. Each session lasts 15 minutes.

This service was performed 12 times for 12 patients

Follow-up hospital inpatient care per day, typically 25 minutes

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.

This service was performed 142 times for 54 patients

Initial hospital inpatient care per day, typically 50 minutes

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

This service was performed 33 times for 33 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 66 times for 64 patients

New patient office or other outpatient visit, 45-59 minutes

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.

This service was performed 21 times for 21 patients

Physician service required to establish and document the need for a power mobility device

This service involves your doctor assessing your mobility needs. They'll document your condition, verify if a power mobility device (like a motorized wheelchair) could improve your life quality, and provide the required medical records to insurance for coverage.

This service was performed 14 times for 14 patients

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Whitney Pratt is affiliated with the following medical facilities:

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