DR. PRIYA PRAKASH M.D.
NPI 1225374085
Internal Medicine - Rheumatology in Clermont, FL

Active since December 26, 2012PECOS EnrolledAccepts Medicare Assignment
88.05/100
CMS Quality Rating
2611 S US HWY 27, CLERMONT, FL 34711(352) 717-0603(352) 717-0604 Get Directions Write a Review

NPPES record last updated: November 14, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 14, 2024, Jun 3, 2024, Feb 28, 2021 and 2 more (5 updates tracked since 2017).

About Dr. Priya Prakash M.d. NPPES

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

DR. PRIYA PRAKASH M.D. (NPI 1225374085) is an individual rheumatology provider in Clermont, Florida, licensed in Florida (ME144273) and active in the NPI registry since December 2012. She is enrolled in Medicare PECOS, is affiliated with Orlando Health, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1225374085
Entity TypeIndividualFemale
Primary Taxonomy207RR0500X
Provider Legal NameDR. PRIYA PRAKASHCredential: M.D.
Location Address2611 S US HWY 27Clermont, FL 34711-6699
Mailing Address2611 S Us Hwy 27Clermont, FL 34711-6699 · (352) 717-0603 · Fax (352) 717-0604
Fax(352) 717-0604
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateDecember 26, 2012
Last NPPES UpdateNovember 14, 20245 updates tracked since enumeration
NPPES CertifiedNovember 12, 2024
NPI 1225374085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
Licenses Licensed in FL · ME144273 Licensed in OK · 32647
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
2611 S US HWY 27, Clermont, FL 34711

Other Identifiers 1

Medicaid109171000FL

Accepted 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. Priya Prakash M.d. 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 ID4183995772
PECOS Enrollment IDI20210122002107
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 23

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.

Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) J0717
Certolizumab pegol is a medication injected under a doctor's supervision. It's used to treat certain inflammatory conditions like rheumatoid arthritis. The injection helps reduce symptoms like pain and swelling. Note that this drug isn't for self-administration.
113,600 services44 patients
Injection, tocilizumab, 1 mg J3262
Tocilizumab is a medication administered via injection. It's used to treat certain conditions like rheumatoid arthritis by reducing inflammation in the body. It works by blocking a substance in the body that leads to inflammation.
56,120 services17 patients
Injection, romosozumab-aqqg, 1 mg J3111
Romosozumab-aqqg is a medication given by injection to treat osteoporosis in patients at high risk for fractures. It works by increasing bone mass and strength, reducing the risk of fractures.
36,330 services35 patients
Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) J0129
Abatacept is a medication administered via injection under a doctor's supervision. It's used to treat conditions like rheumatoid arthritis by moderating the immune system. This code applies when the doctor administers the drug, not for self-administration.
12,550 services26 patients
Injection, golimumab, 1 mg, for intravenous use J1602
Golimumab is a medication given through an IV (a small tube in your vein). It helps to reduce inflammation and pain by blocking a protein in your body that causes inflammation. It's often used to treat conditions like rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.
8,100 services12 patients
Injection, denosumab, 1 mg J0897
Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.
7,740 services76 patients

Hospital Affiliations CMS Care Compare 5

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

Orlando Health

Acute Care Hospitals · Orlando, FL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100006
Location52 W Underwood StOrlando, FL 32806 · Orange County
Emergency services Birthing friendly

Adventhealth Orlando

Acute Care Hospitals · Orlando, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100007
Location601 E Rollins StOrlando, FL 32803 · Orange County
Emergency services Birthing friendly

Orlando Health-Health Central Hospital

Acute Care Hospitals · Ocoee, FL
2/5 CMS rating
OwnershipGovernment - State
CMS Certification Number100030
Location10000 W Colonial DrOcoee, FL 34761 · Orange County
Emergency services

Orlando Health South Lake Hospital

Acute Care Hospitals · Clermont, FL
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100051
Location1900 Don Wickham DrClermont, FL 34711 · Lake County
Birthing friendly

Adventhealth Waterman

Acute Care Hospitals · Tavares, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number100057
Location1000 Waterman WayTavares, FL 32778 · Lake County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34711 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

88.05/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality76.11
Improvement Activities40

Reported Quality Measures

Documentation of Current Medications in the Medical Record
92%6,356 patients3/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
96%3,016 patients4/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 73% · 1,907 patients
Patients screened: 73% · 1,907 patients
100%47 patients5/55-star benchmark: 100%
Rheumatoid Arthritis (RA): Periodic Assessment of Disease Activity
100%617 patients5/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
82%396 patients4/55-star benchmark: 98%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 994 patients
Patients totalRate: 1% · 994 patients
1%994 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES

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

Internal Medicine (Rheumatology)
2611 S US HWY 27
CLERMONT, FL 34711

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 Priya Prakash's NPI number?

The NPI number for Priya Prakash is 1225374085. It was assigned to this individual provider in the NPPES registry on December 26, 2012.

Where is Priya Prakash located?

Priya Prakash practices at 2611 S Us Hwy 27, Clermont, FL 34711. The listed phone number is (352) 717-0603.

What is Priya Prakash's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Priya Prakash enrolled in Medicare?

Yes. Priya Prakash 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 Priya Prakash accept?

Health plans from AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Health First Commercial Plans, Inc. and Oscar Health Maintenance Organization of Florida and 1 other insurer list Priya Prakash 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 Priya Prakash affiliated with any hospitals?

According to CMS data, Priya Prakash is affiliated with Orlando Health, Adventhealth Orlando, Orlando Health-Health Central Hospital, Orlando Health South Lake Hospital and Adventhealth Waterman.

When was this NPI record last updated?

The NPPES record for Priya Prakash was last updated on November 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.