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TIMOTHY JAMES PRATT M.D.
NPI 1104872068
Internal Medicine in Fenton, MO

Active since May 25, 2006PECOS Enrolled
1011 BOWLES AVENUE, SUITE 121, FENTON, MO 63026(314) 766-2066(636) 326-1802 Get Directions Write a Review

NPPES record last updated: June 19, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Timothy James Pratt M.d. NPPES

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

TIMOTHY JAMES PRATT M.D. (NPI 1104872068) is an individual internal medicine provider in Fenton, Missouri, licensed in Missouri (R9E55) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Ssm St Clare Health Center, and is a graduate of Tulane University School Of Medicine (1983).

NPPES Registry Identity

NPI1104872068
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameTIMOTHY JAMES PRATTCredential: M.D.
Location Address1011 BOWLES AVENUE, SUITE 121Fenton, MO 63026
Mailing AddressPo Box 220375Kirkwood, MO 63122-0375 · (314) 766-2066 · Fax (636) 326-1802
Phone(314) 766-2066
Fax(636) 326-1802
Sole ProprietorYes
Medical School CMSTulane University School Of MedicineGraduated 1983
Enumeration DateMay 25, 2006
Last NPPES UpdateJune 19, 2024
NPPES CertifiedJune 19, 2024
✔ NPI 1104872068 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MO · R9E55
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.
1011 BOWLES AVENUE, Fenton, MO 63026
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Other Identifiers 1

Medicaid202477915MO

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 (PECOS)

Timothy James Pratt M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6709789589
PECOS Enrollment IDI20100831000873
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 Reassignment

Medicare enrollment records show Timothy Pratt reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ssm Health Care St Louis
Same address
Emergency Medicine
1015 BOWLES AVENUE
Fenton, MO 63026
  • Reassigned Medicare billing, Missouri enrollment
  • 741 clinicians in this Medicare group
NPI 1275586174 (636) 496-2502

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 7

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.

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
55 services55 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.
49 services32 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
18 services18 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.
18 services12 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
18 services18 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
17 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Ssm St Clare Health Center

Acute Care Hospitals · Fenton, MO
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260081
Location1015 BowlesFenton, MO 63026 · Jefferson County
Emergency services Birthing friendly

Ssm Health St Mary's Hospital - St Louis

Acute Care Hospitals · Richmond Heights, MO
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260091
Location6420 Clayton RdRichmond Heights, MO 63117 · St. Louis County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63026 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
$128.28 typical visit price
range $55.65 – $169.38
Typical copayment $32.07 (range $13.91 – $42.34)
Most-billed visit code 99204
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
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.

Other Providers at the Same Location NPPES 6

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

ANASTASIA A AVERBUKH NP
Nurse Practitioner (Family)
1011 BOWLES AVENUE, SUITE 121
FENTON, MO 63026
St. Louis County (314) 200-2713
RICHARD FELIX WITTOCK III D.P.M.
Podiatrist
1011 BOWLES AVENUE, SUITE 123
FENTON, MO 63026
St. Louis County (636) 717-1100
DOUGLAS DRIPPS M.D.
Internal Medicine
1011 BOWLES AVENUE, SUITE 300
FENTON, MO 63026
St. Louis County (636) 496-5000
ST LOUIS DERMATOLOGY LLC
Dermatology
1011 BOWLES AVENUE, SUITE 121
FENTON, MO 63026
St. Louis County (314) 200-2713
ANKLE AND FOOT INSTITUTE OF MISSOURI P.C.
Podiatrist
1011 BOWLES AVENUE, SUITE 123
FENTON, MO 63026
St. Louis County (636) 717-1100
DR. ALLISON K DAVIS M.D.
Surgery
1011 BOWLES AVENUE, SUITE 425
FENTON, MO 63026
St. Louis County (636) 496-5080

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 Timothy Pratt's NPI number?

The NPI number for Timothy Pratt is 1104872068. It was assigned to this individual provider in the NPPES registry on May 25, 2006.

Where is Timothy Pratt located?

Timothy Pratt practices at 1011 Bowles Avenue Suite 121, Fenton, MO 63026. The listed phone number is (314) 766-2066.

What is Timothy Pratt's specialty?

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

Is Timothy Pratt enrolled in Medicare?

Yes. Timothy Pratt is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Timothy Pratt's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Timothy Pratt reassigns Medicare benefits to Ssm Health Care St Louis (Fenton, MO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Timothy Pratt's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Timothy Pratt accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 5 other insurers list Timothy Pratt 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 Timothy Pratt affiliated with any hospitals?

According to CMS data, Timothy Pratt is affiliated with Ssm St Clare Health Center and Ssm Health St Mary's Hospital - St Louis.

When was this NPI record last updated?

The NPPES record for Timothy Pratt was last updated on June 19, 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.