Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ROBERT ALAN PRUETT III AGACNP-BC
NPI 1295665453
Nurse Practitioner in Fort Wayne, IN

Q: What is Robert Pruett's NPI number?

The NPI number for Robert Pruett is 1295665453. It was assigned to this individual provider in the NPPES registry on May 20, 2026.

Q: What is Robert Pruett's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Robert Pruett was last updated on August 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.

Active since May 20, 2026PECOS Enrolled

11104 PARKVIEW CIRCLE DR STE 110, FORT WAYNE, IN 46845(260) 425-6780(260) 425-6789 Get Directions Write a Review

NPPES record last updated: August 24, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Aug 24, 2026, May 20, 2026 (2 updates tracked since 2026).

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About Robert Alan Pruett Iii Agacnp-bc NPPES

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

ROBERT ALAN PRUETT III AGACNP-BC (NPI 1295665453) is an individual nurse practitioner in Fort Wayne, Indiana, licensed in Indiana (71018191A) and active in the NPI registry since May 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1295665453

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameROBERT ALAN PRUETT IIICredential: AGACNP-BC

Location Address11104 PARKVIEW CIRCLE DR STE 110Fort Wayne, IN 46845-1673

Mailing Address11109 Parkview Plaza Dr # 117Fort Wayne, IN 46845-1701 · (260) 668-0033

Phone(260) 425-6780

Fax(260) 425-6789

Sole ProprietorNo

Enumeration DateMay 20, 2026

Last NPPES UpdateAugust 24, 20262 updates tracked since enumeration

NPPES CertifiedAugust 24, 2026

✔ NPI 1295665453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in IN · 71018191A

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

11104 PARKVIEW CIRCLE DR STE 110, Fort Wayne, IN 46845

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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)

Robert Alan Pruett Iii Agacnp-bc 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46845 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

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

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 20

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

DR. KELLEY RAE LOCKHART M.D.

Internal Medicine (Critical Care Medicine)