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DR. RICHARD PROKESCH M.D.
NPI 1427064583
Internal Medicine - Infectious Disease in Riverdale, GA

Active since July 31, 2006PECOS EnrolledAccepts Medicare Assignment
6285 GARDEN WALK BLVD, STE A, RIVERDALE, GA 30274(770) 991-1150(770) 991-9047 Get Directions Write a Review

NPPES record last updated: September 15, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Richard Prokesch M.d. NPPES

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

DR. RICHARD PROKESCH M.D. (NPI 1427064583) is an individual infectious disease provider in Riverdale, Georgia, licensed in Georgia (019754) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Piedmont Henry Hospital, and is a graduate of New York Medical College (1976).

NPPES Registry Identity

NPI1427064583
Entity TypeIndividualMale
Primary Taxonomy207RI0200X
Provider Legal NameDR. RICHARD PROKESCHCredential: M.D.
Location Address6285 GARDEN WALK BLVD, STE ARiverdale, GA 30274-2612
Mailing Address6285 Garden Walk Blvd, Ste ARiverdale, GA 30274-2612 · (770) 991-1150 · Fax (770) 991-9047
Phone(770) 991-1150
Fax(770) 991-9047
Sole ProprietorYes
Medical School CMSNew York Medical CollegeGraduated 1976
Enumeration DateJuly 31, 2006
Last NPPES UpdateSeptember 15, 2008
✔ NPI 1427064583 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
License✔ Licensed in GA · 019754
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
6285 GARDEN WALK BLVD, Riverdale, GA 30274
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Other Identifiers 2

Medicare UPIND30519GA
Medicaid00159057AGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health 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

Dr. Richard Prokesch 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 ID2668411570
PECOS Enrollment IDI20060315000564, I20190319000054
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 7

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
400 services104 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
84 services46 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
80 services69 patients
Telephone or internet assessment with verbal and written report by consulting physician, 21-30 minutes 99448
This is a virtual consultation with a specialist doctor lasting between 21-30 minutes. It can take place over the phone or internet. After the session, the doctor will provide a written report about your health condition and any recommended next steps.
53 services28 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
49 services32 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
19 services19 patients

Hospital Affiliations CMS Care Compare 2

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

Piedmont Henry Hospital

Acute Care Hospitals · Stockbridge, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110191
Location1133 Eagle's Landing ParkwayStockbridge, GA 30281 · Henry County
Emergency services Birthing friendly

Froedtert Community Hospital

Acute Care Hospitals · New Berlin, WI
OwnershipVoluntary non-profit - Private
CMS Certification Number520213
Location4805 S Moorland RdNew Berlin, WI 53151 · Waukesha County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30274 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
42%125 patients2/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%1,059 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.
51%529 patients2/55-star benchmark: 100%
HIV Medical Visit Frequency
Percentage of patients, regardless of age with a diagnosis of HIV who had at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits
48%188 patients2/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
84%58 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
26%502 patients2/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
93%325 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…
61%184 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
46%184 patients3/55-star benchmark: 79%
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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mg J1599
Treatment-Injections and Infusions (nononcologic) · category RI008N
1 supplier14 claims1,120 services$55.39 avg. paid by Medicare
Services, supplies and accessories used in the home under the medicare intravenous immune globulin (ivig) demonstration Q2052
Treatment-Chemotherapy · category RH012N
1 supplier14 claims14 services$310.21 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

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

CENTER NEUROLOGY, P.C.
Specialist
6285 GARDEN WALK BLVD, SUITE C
RIVERDALE, GA 30274
Clayton County (770) 996-1352
DR. LEE A DIAMOND M.D.
Internal Medicine (Infectious Disease)
6285 GARDEN WALK BLVD, STE A
RIVERDALE, GA 30274
Clayton County (770) 991-1500
DR. JOSEPH N. SABA M.D.
Specialist
6285 GARDEN WALK BLVD, SUITE C
RIVERDALE, GA 30274
Clayton County (770) 996-1352
INFECTIOUS DISEASES ASSOCIATES, PC
Internal Medicine (Infectious Disease)
6285 GARDEN WALK BLVD, STE A
RIVERDALE, GA 30274
Clayton County (770) 991-1500
INFECTIOUS DISEASE ASSOCIATES 2 LLC
Obstetrics & Gynecology (Gynecologic Oncology)
6285 GARDEN WALK BLVD, SUITE A
RIVERDALE, GA 30274
Clayton County (404) 943-0205

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 Richard Prokesch's NPI number?

The NPI number for Richard Prokesch is 1427064583. It was assigned to this individual provider in the NPPES registry on July 31, 2006.

Where is Richard Prokesch located?

Richard Prokesch practices at 6285 Garden Walk Blvd Ste A, Riverdale, GA 30274. The listed phone number is (770) 991-1150.

What is Richard Prokesch's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Richard Prokesch enrolled in Medicare?

Yes. Richard Prokesch 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 Richard Prokesch accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 9 other insurers list Richard Prokesch 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 Richard Prokesch affiliated with any hospitals?

According to CMS data, Richard Prokesch is affiliated with Piedmont Henry Hospital and Froedtert Community Hospital.

When was this NPI record last updated?

The NPPES record for Richard Prokesch was last updated on September 15, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.