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FIONA R. PRABHU M.D.
NPI 1770575730
Family Medicine in Lubbock, TX

Active since August 16, 2005PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
3601 4TH ST, SUITE 1C143, LUBBOCK, TX 79430(806) 743-2757(806) 743-2563 Get Directions Write a Review

NPPES record last updated: January 10, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Fiona R. Prabhu M.d. NPPES

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

FIONA R. PRABHU M.D. (NPI 1770575730) is an individual family medicine provider in Lubbock, Texas, licensed in Texas (K0545) and active in the NPI registry since August 2005. She is enrolled in Medicare PECOS, is affiliated with Covenant Medical Center, and is a graduate of Texas A & M University System, Hsc, College Of Medicine (1995).

NPPES Registry Identity

NPI1770575730
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameFIONA R. PRABHUCredential: M.D.
Location Address3601 4TH ST, SUITE 1C143Lubbock, TX 79430-8143
Mailing AddressPo Box 5865Lubbock, TX 79408-5865 · (806) 743-2898 · Fax (806) 743-2787
Phone(806) 743-2757
Fax(806) 743-2563
Sole ProprietorNo
Medical School CMSTexas A & M University System, Hsc, College Of MedicineGraduated 1995
Enumeration DateAugust 16, 2005
Last NPPES UpdateJanuary 10, 2020
✔ NPI 1770575730 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TX · K0545
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3601 4TH ST, Lubbock, TX 79430
Open in Google Maps ↗

Other Identifiers 11

Other121753100TX · Firstcare Commercial
Other86797NM · Presbyterian Commercial
Medicaid124998901TX
Other87811GTX · Bcbs
MedicaidP3642NM
Medicaid86797NM
Medicaid121753103TX
Medicaid124998903TX
Other82830ZTX · Hmo Blue
Medicaid100008000AOK
OtherA002NM · Triwest

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.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

Fiona R. Prabhu 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 ID2668483439
PECOS Enrollment IDI20060508000609
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.

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.
109 services66 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
86 services33 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
47 services42 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
33 services33 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
23 services14 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
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.

Covenant Medical Center

Acute Care Hospitals · Lubbock, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450040
Location3615 19th StreetLubbock, TX 79410 · Lubbock County
Emergency services

University Medical Center

Acute Care Hospitals · Lubbock, TX
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number450686
Location602 Indiana AvenueLubbock, TX 79415 · Lubbock County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 79430 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality91.19
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims

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

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers13 claims13 services$69.23 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 20

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

JAMES STEVEN DEMBOWSKI PHD
Speech-Language Pathologist
3601 4TH ST, STE. 2A300
LUBBOCK, TX 79430
Lubbock County (806) 743-5678
CHARLES KIM D.O.
Anesthesiology
3601 4TH ST
LUBBOCK, TX 79430
Lubbock County (806) 743-3004
BAILEY WADDINGTON MD
Student in an Organized Health Care Education/Training Program
3601 4TH ST
LUBBOCK, TX 79430
Lubbock County (806) 743-6840
SARA SYED AHMED MD
Psychiatry & Neurology (Psychiatry)
3601 4TH ST
LUBBOCK, TX 79430
Lubbock County (806) 743-2800
DR. SAFAA S. LABIB M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
3601 4TH ST, SUITE 1A115
LUBBOCK, TX 79430
Lubbock County (806) 743-2155
MATTHEW PAUL FERGUSON M.D.
Orthopaedic Surgery (Sports Medicine)
3601 4TH ST
LUBBOCK, TX 79430
Lubbock County (806) 743-2475
KORY NOEL HOWELL DO
Student in an Organized Health Care Education/Training Program
3601 4TH ST
LUBBOCK, TX 79430
Lubbock County (806) 743-3381
JANICE STACHOWIAK M.D.
Internal Medicine
3601 4TH ST
LUBBOCK, TX 79430
Lubbock County (806) 743-3150

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 Fiona Prabhu's NPI number?

The NPI number for Fiona Prabhu is 1770575730. It was assigned to this individual provider in the NPPES registry on August 16, 2005.

Where is Fiona Prabhu located?

Fiona Prabhu practices at 3601 4th St Suite 1c143, Lubbock, TX 79430. The listed phone number is (806) 743-2757.

What is Fiona Prabhu's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Fiona Prabhu enrolled in Medicare?

Yes. Fiona Prabhu 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 Fiona Prabhu accept?

Health plans from Blue Cross and Blue Shield of Texas list Fiona Prabhu 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 Fiona Prabhu affiliated with any hospitals?

According to CMS data, Fiona Prabhu is affiliated with Covenant Medical Center and University Medical Center.

When was this NPI record last updated?

The NPPES record for Fiona Prabhu was last updated on January 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.