DR. RYAN SANFORD PRUDOFF DO
NPI 1740483122
Emergency Medicine in Georgetown, TX
About Dr. Ryan Sanford Prudoff Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. RYAN SANFORD PRUDOFF DO (NPI 1740483122) is an individual emergency medicine provider in Georgetown, Texas, licensed in Texas (R5027) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS and maintains a secondary practice location in Akron.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Ryan Sanford Prudoff Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Ryan Prudoff reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Round Rock, TX 78681
- Reassigned Medicare billing, Texas enrollment
- 81 clinicians in this Medicare group
Austin, TX 78732
- Reassigned Medicare billing, Texas enrollment
- 93 clinicians in this Medicare group
Seaman, OH 45679
- Reassigned Medicare billing, Ohio enrollment
- 894 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 78628 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Ryan Prudoff's NPI number?
The NPI number for Ryan Prudoff is 1740483122. It was assigned to this individual provider in the NPPES registry on June 6, 2007.
Where is Ryan Prudoff located?
Ryan Prudoff practices at 1210 W University Ave, Georgetown, TX 78628. The listed phone number is (216) 513-2236.
What is Ryan Prudoff's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Ryan Prudoff enrolled in Medicare?
Yes. Ryan Prudoff is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Ryan Prudoff's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ryan Prudoff reassigns Medicare benefits to 3 organizations: Brushy Creek Emergency Physicians PLLC (Round Rock, TX), Lake Travis Emergency Physicians, PLLC (Austin, TX) and Emergency Professional Services, Inc. (Seaman, OH). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ryan Prudoff's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Ryan Prudoff was last updated on November 26, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Dr. Ryan Sanford Prudoff, DO · NPI 1740483122
Emergency Medicine physician in Georgetown, Texas. Individual provider, active in the CMS NPPES registry since June 6, 2007.
## Identity
- **NPI:** 1740483122 (Entity type: Individual)
- **Enumerated:** June 6, 2007
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** R5027 (Texas)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1210 W UNIVERSITY AVE, Georgetown, TX 78628-5333
- **Phone:** (216) 513-2236
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Brushy Creek Emergency Physicians PLLC (NPI 1235773151, Round Rock, TX); Lake Travis Emergency Physicians, PLLC (NPI 1851803688, Austin, TX); Emergency Professional Services, Inc. (NPI 1093762353, Seaman, OH) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 26, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1740483122) · Data from the CMS NPPES public registry.