ETHAN A PRAIRIE MD
NPI 1134749195
Family Medicine in Rio Rancho, NM
About Ethan A Prairie Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ETHAN A PRAIRIE MD (NPI 1134749195) is an individual family medicine provider in Rio Rancho, New Mexico, licensed in New Mexico (MD2023-0538) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, is affiliated with Presbyterian Hospital, and is a graduate of University Of New Mexico School Of Medicine (2020).
NPPES Registry Identity
Specialties & Licenses
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
Ethan A Prairie 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.
Medicare Billing Reassignment
Medicare enrollment records show Ethan Prairie reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Albuquerque, NM 87122
- Reassigned Medicare billing, New Mexico enrollment
- 2,331 clinicians in this Medicare group
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 4
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Presbyterian Hospital
Acute Care Hospitals · Albuquerque, NMPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 87124 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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.
RIO RANCHO, NM 87124
RIO RANCHO, NM 87124
RIO RANCHO, NM 87124
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 Ethan Prairie's NPI number?
The NPI number for Ethan Prairie is 1134749195. It was assigned to this individual provider in the NPPES registry on April 20, 2020.
Where is Ethan Prairie located?
Ethan Prairie practices at 4005 High Resort Blvd SE, Rio Rancho, NM 87124. The listed phone number is (505) 462-6000.
What is Ethan Prairie's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Ethan Prairie enrolled in Medicare?
Yes. Ethan Prairie 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.
Which organization bills Medicare for Ethan Prairie's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ethan Prairie reassigns Medicare benefits to Presbyterian Healthcare Services (Albuquerque, NM). 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 Ethan Prairie's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Ethan Prairie affiliated with any hospitals?
According to CMS data, Ethan Prairie is affiliated with Presbyterian Hospital.
When was this NPI record last updated?
The NPPES record for Ethan Prairie was last updated on December 29, 2023. 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.
# Ethan A Prairie, MD · NPI 1134749195
Family Medicine physician in Rio Rancho, New Mexico. Individual provider, active in the CMS NPPES registry since April 20, 2020.
## Identity
- **NPI:** 1134749195 (Entity type: Individual)
- **Enumerated:** April 20, 2020
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** MD2023-0538 (New Mexico)
- **Sole proprietor:** No
## Practice location
- **Address:** 4005 HIGH RESORT BLVD SE, Rio Rancho, NM 87124-5906
- **Phone:** (505) 462-6000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Presbyterian Healthcare Services (NPI 1811233927, Albuquerque, NM), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of New Mexico School Of Medicine, class of 2020
## Record status
- **NPPES last updated:** December 29, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1134749195) · Data from the CMS NPPES public registry.