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PAUL PRIOR M.D.
NPI 1922024256
Obstetrics & Gynecology in Sarasota, FL

Active since July 13, 2006PECOS Enrolled
78.8/100
CMS Quality Rating
1700 S TAMIAMI TRL, SARASOTA, FL 34239(941) 917-8560(941) 917-2675 Get Directions Write a Review

NPPES record last updated: August 17, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 17, 2021, Jul 23, 2019 (2 updates tracked since 2019).

About Paul Prior M.d. NPPES

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

PAUL PRIOR M.D. (NPI 1922024256) is an individual obstetrics & gynecology provider in Sarasota, Florida, licensed in Florida (ME146435) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1922024256
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NamePAUL PRIORCredential: M.D.
Location Address1700 S TAMIAMI TRLSarasota, FL 34239-3509
Mailing AddressPo Box 863407Orlando, FL 32886-3407 · (941) 917-2600 · Fax (941) 917-7884
Phone(941) 917-8560
Fax(941) 917-2675
Sole ProprietorNo
Enumeration DateJuly 13, 2006
Last NPPES UpdateAugust 17, 20212 updates tracked since enumeration
NPPES CertifiedAugust 17, 2021
✔ NPI 1922024256 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Licenses✔ Licensed in FL · ME146435✔ Licensed in OH · 35078532
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
1700 S TAMIAMI TRL, Sarasota, FL 34239
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1781 W Locust StWilmington, OH 45177-2116 · Phone (937) 283-2588
Location 2311 S 15th StCoshocton, OH 43812-1873 · Phone (740) 622-7144

Other Identifiers 1

Medicaid2072475OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Paul Prior M.d. 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Paul Prior reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Smh Physician Services Inc
0.1 mi
Internal Medicine
1700 S TAMIAMI TRL, 1ST FLOOR FPG ADMINISTRATION
Sarasota, FL 34239
  • Reassigned Medicare billing, Florida enrollment
  • 956 clinicians in this Medicare group
NPI 1346295292 (941) 917-8720
Wilmington Physicians Group LLC
839 mi
Family Medicine
610 W MAIN ST
Wilmington, OH 45177
  • Reassigned Medicare billing, Ohio enrollment
  • 74 clinicians in this Medicare group
NPI 1932401411 (937) 382-5438

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 34239 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
Most-billed visit code 99213
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.

78.8/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.37
Promoting Interoperability99
Improvement Activities40
Cost50.81

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. ELIJAH KIM M.D.
Surgery (Surgical Critical Care)
1700 S TAMIAMI TRL
SARASOTA, FL 34239
Sarasota County (941) 917-9000
DR. ENRICO V VINTAYEN MD
Psychiatry & Neurology (Neurology)
1700 S TAMIAMI TRL
SARASOTA, FL 34239
Sarasota County (941) 917-4896
VIRALKUMAR PATEL MD
Internal Medicine
1700 S TAMIAMI TRL
SARASOTA, FL 34239
Sarasota County (941) 917-4896
DR. MAHA HAMEED MBBS
Student in an Organized Health Care Education/Training Program
1700 S TAMIAMI TRL
SARASOTA, FL 34239
Sarasota County (941) 917-7799
ELIZABETH FERNANDEZ PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1700 S TAMIAMI TRL
SARASOTA, FL 34239
Sarasota County (941) 262-7727
RODES ACKERMAN PHARMD
Pharmacist
1700 S TAMIAMI TRL
SARASOTA, FL 34239
Sarasota County (941) 917-3131
MAYURI JINDAL M.D.
Pediatrics
1700 S TAMIAMI TRL
SARASOTA, FL 34239
Sarasota County (941) 917-7490
STEVEN MICHAEL PAPUCHIS DO
Physical Medicine & Rehabilitation (Sports Medicine)
1700 S TAMIAMI TRL
SARASOTA, FL 34239
Sarasota County (941) 917-8561

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 Paul Prior's NPI number?

The NPI number for Paul Prior is 1922024256. It was assigned to this individual provider in the NPPES registry on July 13, 2006.

Where is Paul Prior located?

Paul Prior practices at 1700 S Tamiami Trl, Sarasota, FL 34239. The listed phone number is (941) 917-8560.

What is Paul Prior's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Paul Prior enrolled in Medicare?

Yes. Paul Prior is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Paul Prior's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Paul Prior reassigns Medicare benefits to 2 organizations: Smh Physician Services Inc (Sarasota, FL) and Wilmington Physicians Group LLC (Wilmington, 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 Paul Prior's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Paul Prior accept?

Health plans from CareSource, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Oscar Health Maintenance Organization of Florida list Paul Prior 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.

When was this NPI record last updated?

The NPPES record for Paul Prior was last updated on August 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.