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IAN PRUDHOMME MD
NPI 1780044362
Pathology - Anatomic Pathology & Clinical Pathology in Apo, AA

Active since February 25, 2016PECOS EnrolledAccepts Medicare Assignment
2200 BERGQUIST DR STE 1, WHMC/GE-2200, JBSA LACKLAND AFB, TX, APO, AA 78236(423) 943-2720 Get Directions Write a Review

NPPES record last updated: January 8, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 19, 2017, Feb 25, 2016 (2 updates tracked since 2016).

About Ian Prudhomme Md NPPES

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

IAN PRUDHOMME MD (NPI 1780044362) is an individual anatomic pathology & clinical pathology provider in Apo, AA, licensed in Nebraska (30410) and active in the NPI registry since February 2016. He is enrolled in Medicare PECOS, is affiliated with Hca Florida Twin Cities Hospital, and is a graduate of Uniformed Services Uhs Fe Hebert School Of Med (2016).

NPPES Registry Identity

NPI1780044362
Entity TypeIndividualMale
Primary Taxonomy207ZP0102X
Provider Legal NameIAN PRUDHOMMECredential: MD
Location Address2200 BERGQUIST DR STE 1, WHMC/GE-2200, JBSA LACKLAND AFB, TXApo, AA 78236-5300
Mailing Address2200 Bergquist Dr Ste 1, Whmc/ge-2200Jbsa Lackland Afb, TX 78236-5300
Phone(423) 943-2720
Sole ProprietorNo
Medical School CMSUniformed Services Uhs Fe Hebert School Of MedGraduated 2016
Enumeration DateFebruary 25, 2016
Last NPPES UpdateJanuary 8, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 8, 2024
✔ NPI 1780044362 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
License✔ Licensed in NE · 30410
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
2200 BERGQUIST DR STE 1, Apo, AA 78236
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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 and accepts Medicare assignment

Ian Prudhomme Md 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 ID3678054103
PECOS Enrollment IDI20260223004045
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.

Hospital Affiliations CMS Care Compare 3

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

Hca Florida Twin Cities Hospital

Acute Care Hospitals · Niceville, FL
4/5 CMS rating
OwnershipProprietary
CMS Certification Number100054
Location2190 Hwy 85 NNiceville, FL 32578 · Okaloosa County
Emergency services

Hca Florida Fort Walton-Destin Hospital

Acute Care Hospitals · Fort Walton Beach, FL
3/5 CMS rating
OwnershipProprietary
CMS Certification Number100223
Location1000 Mar-Walt DrFort Walton Beach, FL 32547 · Okaloosa County
Emergency services Birthing friendly

Hca Florida Gulf Coast Hospital

Acute Care Hospitals · Panama City, FL
3/5 CMS rating
OwnershipProprietary
CMS Certification Number100242
Location449 W 23rd StPanama City, FL 32405 · Bay County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78236 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
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.

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.

RISA CAVALCANTI RIEPMA RD
Dietitian, Registered
2200 BERGQUIST DR STE 1, ATTN: CREDENTIALS (CMC)
LACKLAND AFB, TX 78236
Bexar County (210) 292-5737
DR. JILL L STERLING M.D.
Internal Medicine (Critical Care Medicine)
2200 BERGQUIST DR STE 1, ATTN: CREDENTIALS (CMC)
LACKLAND A F B, TX 78236
Bexar County (210) 292-7195
MR. JARED BRIAN COOPER
Student in an Organized Health Care Education/Training Program
2200 BERGQUIST DR STE 1
LACKLAND A F B, TX 78236
Bexar County (210) 292-5968
JENNY H. RAINWATER AU.D.
Audiologist
2200 BERGQUIST DR STE 1, ATTN: CREDENTIALS (CMC)
LACKLAND A F B, TX 78236
Bexar County (210) 292-6707
DR. SUSAN WRIGHT MONGEAU DDS, MPH
Dentist (Dental Public Health)
2200 BERGQUIST DR STE 1
LACKLAND AFB, TX 78236
Bexar County (210) 925-1846
MR. THOMAS LOUIS DUQUETTE P.T.
Physical Therapist
2200 BERGQUIST DR STE 1, ATTN: CREDENTIALS (CMC)
LACKLAND A F B, TX 78236
Bexar County (210) 292-6707
DR. JAMES R.T. BALES M.D.
Orthopaedic Surgery
2200 BERGQUIST DR STE 1
LACKLAND A F B, TX 78236
Bexar County (210) 292-5875
MS. SONJA L BANKS-GAY RPH
Pharmacist
2200 BERGQUIST DR STE 1
LACKLAND, TX 78236
Bexar County (210) 292-7100

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 Ian Prudhomme's NPI number?

The NPI number for Ian Prudhomme is 1780044362. It was assigned to this individual provider in the NPPES registry on February 25, 2016.

Where is Ian Prudhomme located?

Ian Prudhomme practices at 2200 Bergquist Dr Ste 1 Whmc/Ge-2200, Jbsa Lackland Afb, Tx, Apo, AA 78236. The listed phone number is (423) 943-2720.

What is Ian Prudhomme's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is Ian Prudhomme enrolled in Medicare?

Yes. Ian Prudhomme 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.

Is Ian Prudhomme affiliated with any hospitals?

According to CMS data, Ian Prudhomme is affiliated with Hca Florida Twin Cities Hospital, Hca Florida Fort Walton-Destin Hospital and Hca Florida Gulf Coast Hospital.

When was this NPI record last updated?

The NPPES record for Ian Prudhomme was last updated on January 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.