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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.

JOHN PRUITT
NPI 1245974310
Student in an Organized Health Care Education/Training Program in Austin, TX

Active since April 25, 2022PECOS Enrolled
12554 RIATA VISTA CIR, AUSTIN, TX 78727(337) 502-6704 Get Directions Write a Review

NPPES record last updated: July 23, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jul 23, 2026, Apr 25, 2022 (2 updates tracked since 2022).

About John Pruitt NPPES

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

JOHN PRUITT (NPI 1245974310) is an individual student in an organized health care education/training program in Austin, Texas and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245974310
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJOHN PRUITT
Location Address12554 RIATA VISTA CIRAustin, TX 78727-6431
Mailing Address4000 Beaconsdale DrAustin, TX 78727-2955 · (337) 502-6704
Phone(337) 502-6704
Sole ProprietorYes
Enumeration DateApril 25, 2022
Last NPPES UpdateJuly 23, 20262 updates tracked since enumeration
NPPES CertifiedJuly 23, 2026
✔ NPI 1245974310 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
12554 RIATA VISTA CIR, Austin, TX 78727
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

John Pruitt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

DR. GREGORY CONNOR MD
Radiology (Diagnostic Radiology)
12554 RIATA VISTA CIR
AUSTIN, TX 78727
Travis County (512) 795-5100
AUSTIN RADIOLOGICAL ASSOCIATION
Clinic/Center (Radiology)
12554 RIATA VISTA CIR
AUSTIN, TX 78727
Travis County (512) 795-5100
DR. BRADLEY BRENNER MD
Radiology (Diagnostic Radiology)
12554 RIATA VISTA CIR
AUSTIN, TX 78727
Travis County (512) 795-5100
DR. MAEGAN KELLIE GARCIA LAZAGA M.D.
Radiology (Diagnostic Radiology)
12554 RIATA VISTA CIR
AUSTIN, TX 78727
Travis County (512) 795-5100
ERIC EDWARD MAHLMANN
Physician Assistant
12554 RIATA VISTA CIR
AUSTIN, TX 78727
Travis County (512) 795-5100
SETH D. O'BRIEN M.D.
Radiology (Diagnostic Radiology)
12554 RIATA VISTA CIR
AUSTIN, TX 78727
Travis County (512) 795-5100
KAETHAN BYSANI DO
Radiology (Diagnostic Radiology)
12554 RIATA VISTA CIR
AUSTIN, TX 78727
Travis County (512) 795-5100
MICHAEL A. JAIMES M.D.
Radiology (Vascular & Interventional Radiology)
12554 RIATA VISTA CIR
AUSTIN, TX 78727
Travis County (512) 795-5100

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 John Pruitt's NPI number?

The NPI number for John Pruitt is 1245974310. It was assigned to this individual provider in the NPPES registry on April 25, 2022.

Where is John Pruitt located?

John Pruitt practices at 12554 Riata Vista Cir, Austin, TX 78727. The listed phone number is (337) 502-6704.

What is John Pruitt's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is John Pruitt enrolled in Medicare?

Yes. John Pruitt is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for John Pruitt was last updated on July 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 34 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.