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ROMAN O PRAVAK M.D.
NPI 1275582082
Ophthalmology in Fountain Hill, PA

Active since May 09, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
800 OSTRUM ST STE 100, FOUNTAIN HILL, PA 18015(484) 526-3010(484) 526-3591 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Jul 3, 2017, Oct 18, 2016 and 1 more (4 updates tracked since 2016).

About Roman O Pravak M.d. NPPES

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

ROMAN O PRAVAK M.D. (NPI 1275582082) is an individual ophthalmology provider in Fountain Hill, Pennsylvania, licensed in Pennsylvania (MD444521) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and is a graduate of State University Of Ny Upstate Medical University (1998).

NPPES Registry Identity

NPI1275582082
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameROMAN O PRAVAKCredential: M.D.
Location Address800 OSTRUM ST STE 100Fountain Hill, PA 18015-1010
Mailing Address800 Ostrum St Ste 100Fountain Hill, PA 18015-1010 · (484) 526-3010 · Fax (484) 526-3591
Phone(484) 526-3010
Fax(484) 526-3591
Sole ProprietorNo
Medical School CMSState University Of Ny Upstate Medical UniversityGraduated 1998
Enumeration DateMay 9, 2006
Last NPPES UpdateJuly 21, 20224 updates tracked since enumeration
✔ NPI 1275582082 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses✔ Licensed in PA · MD444521✔ Licensed in FL · ME94998
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Also ListedOphthalmology · Retina SpecialistTaxonomy 207WX0107X · License MD444521 (PA)
800 OSTRUM ST STE 100, Fountain Hill, PA 18015
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Other Identifiers 2

Medicaid102724414-0001PA
Medicaid276217000FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare and more.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

Roman O Pravak 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 ID5395711055
PECOS Enrollment IDI20060816000379
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 10

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, faricimab-svoa, 0.1 mg J2777
Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.
22,320 services72 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
1,257 services583 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
1,043 services663 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
894 services185 patients
Injection, aflibercept, 1 mg J0178
Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.
492 services55 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
148 services148 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18015 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
Most-billed visit code 99213
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40

Reported Quality Measures

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%113 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
44%66 patients2/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%719 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
52%651 patients3/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
80%143 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
8%948 patients1/55-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.

PRAVAK & ASSOCIATES PC
Ophthalmology
800 OSTRUM ST STE 100
FOUNTAIN HILL, PA 18015
Northampton County (484) 526-3010

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 Roman Pravak's NPI number?

The NPI number for Roman Pravak is 1275582082. It was assigned to this individual provider in the NPPES registry on May 9, 2006.

Where is Roman Pravak located?

Roman Pravak practices at 800 Ostrum St Ste 100, Fountain Hill, PA 18015. The listed phone number is (484) 526-3010.

What is Roman Pravak's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Roman Pravak enrolled in Medicare?

Yes. Roman Pravak 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 Roman Pravak accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare and UnitedHealthcare list Roman Pravak 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.

When was this NPI record last updated?

The NPPES record for Roman Pravak was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.