DR. ARTURO PRADA MD
NPI 1427030147
Internal Medicine in Rochester Hills, MI
NPI Status: Active since November 17, 2005
Contact Information
6700 N ROCHESTER RD
SUITE 110
ROCHESTER HILLS, MI
ZIP 48306
Phone: (248) 652-1202
Fax: (248) 652-8520
- NPI Profile Information
- Primary Taxonomy
- Insurance Plans Accepted
- Medicare Participation & PECOS Status
- Areas of Expertise
- Durable Medical Equipment
- Physician Visit Costs
- Quality Reporting
- Hospital Affiliations - Privileges
- CLIA Information
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
- Individual
- Male
- Years of Experience 56
- Internal Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
- CLIA Number: 23D0371422
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-22-2025
About ARTURO PRADA
This page provides the complete NPI Profile along with additional information for Arturo Prada, an internist established in Rochester Hills, Michigan with a medical specialization in Internal Medicine and more than 56 years of experience. The healthcare provider is registered in the NPI registry with number 1427030147 assigned on November 2005. The practitioner's primary taxonomy code is 207R00000X with license number 4301034898 (MI). The provider is registered as an individual and his NPI record was last updated 16 years ago.
- NPI
- 1427030147
- Provider Name
- DR. ARTURO PRADA MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 6700 N ROCHESTER RD SUITE 110 ROCHESTER HILLS, MI 48306
- Location Phone
- (248) 652-1202
- Location Fax
- (248) 652-8520
- Mailing Address
- 6700 N ROCHESTER RD SUITE 110 ROCHESTER HILLS, MI 48306
- Mailing Phone
- (248) 652-1202
- Mailing Fax
- (248) 652-8520
- Medical School Name
- OTHER
- Graduation Year
- 1970
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 11-17-2005
- Last Update Date
- 01-19-2010
- Code Navigator
An internist like Arturo Prada is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 4301034898
- License State
- MI
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Clear Silver - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Blue Cross� Local HMO Bronze Extra - HMO
- Blue Cross� Local HMO Bronze Secure - HMO
- Blue Cross� Local HMO Silver Extra - HMO
- Blue Cross� Local HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Bronze Extra - HMO
- Blue Cross� Preferred HMO Bronze Saver HSA - HMO
- Blue Cross� Preferred HMO Bronze Secure - HMO
- Blue Cross� Preferred HMO Gold - HMO
- Blue Cross� Preferred HMO Gold Extra - HMO
- Blue Cross� Preferred HMO Silver - HMO
- Blue Cross� Preferred HMO Silver Extra - HMO
- Blue Cross� Preferred HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Value - HMO
- Blue Cross� Select HMO Bronze Extra - HMO
- Blue Cross� Select HMO Bronze Saver HSA - HMO
- Blue Cross� Select HMO Bronze Secure - HMO
- Blue Cross� Select HMO Silver - HMO
- Blue Cross� Select HMO Silver Extra - HMO
- Blue Cross� Select HMO Silver Saver - HMO
- Blue Cross� Select HMO Value - HMO
- Blue Cross� Premier PPO Bronze Extra - PPO
- Blue Cross� Premier PPO Bronze HSA - PPO
- Blue Cross� Premier PPO Bronze Secure - PPO
- Blue Cross� Premier PPO Gold - PPO
- Blue Cross� Premier PPO Gold Extra - PPO
- Blue Cross� Premier PPO Silver - PPO
- Blue Cross� Premier PPO Silver Extra - PPO
- Blue Cross� Premier PPO Silver Saver HSA - PPO
- Blue Cross� Premier PPO Value - PPO
- Bronze First - HMO
- Bronze First Adult Vision & Fitness - HMO
- Diabetes Gold - HMO
- Diabetes Gold Adult Vision & Fitness - HMO
- Diabetes Silver - HMO
- Diabetes Silver Adult Vision & Fitness - HMO
- Gold - HMO
- Gold Adult Vision & Fitness - HMO
- HDHP Preventive Silver - HMO
- Healthy Heart Gold - HMO
- Healthy Heart Gold Adult Vision & Fitness - HMO
- Healthy Heart Silver - HMO
- Healthy Heart Silver Adult Vision & Fitness - HMO
- Low Premium Silver - HMO
- Low Premium Silver Adult Vision & Fitness - HMO
- Silver - HMO
- Silver Adult Vision & Fitness - HMO
- MHP Bronze - HMO
- MHP Bronze Saver (Expanded) - HMO
- MHP Expanded Bronze Standard - HMO
- MHP Gold - HMO
- MHP Gold Standard - HMO
- MHP Silver Exchange - HMO
- MHP Silver Exchange Rewards - HMO
- MHP Silver Standard - HMO
- MHP Young Adult/Catastrophic - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- MyPriority Balanced Silver - HMO
- MyPriority Balanced Silver Southeast Michigan Network - HMO
- MyPriority Enhanced Gold Southeast Michigan Network - HMO
- MyPriority Premier Silver - HMO
- MyPriority Premier Silver Southeast Michigan Network - HMO
- MyPriority Standard Bronze - HMO
- MyPriority Standard Bronze - Southeast Michigan Network - HMO
- MyPriority Standard Bronze - Travel - HMO
- MyPriority Standard Gold - HMO
- MyPriority Standard Gold Southeast Michigan Network - HMO
- MyPriority Standard Silver - HMO
- MyPriority Standard Silver - Southeast Michigan Network - HMO
- MyPriority Standard Silver - Travel - HMO
- MyPriority Value Bronze - HMO
- MyPriority Value Bronze HSA - HMO
- MyPriority Value Bronze HSA Southeast Michigan Network - HMO
- MyPriority Value Bronze Southeast Michigan Network - HMO
- UHC Bronze Copay Focus (No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Value (No Referrals) - HMO
- UHC Bronze Value+ (Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage (No Referrals) - HMO
- UHC Gold Advantage+ (Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus (No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Silver Advantage (No Referrals) - HMO
- UHC Silver Advantage+ (Dental + Vision, No Referrals) - HMO
- UHC Silver Standard (No Referrals) - HMO
- UHC Silver Value (No Referrals) - HMO
- UHC Silver Value+ (Dental + Vision, No Referrals) - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| E21178 | MEDICARE UPIN (02) | ||
| 1373447 | MEDICAID (05) | MI | |
| 0632743111 | MEDICARE ID-TYPE UNSPECIFIED (04) |
Medicare Participation & PECOS Enrollment Status
Arturo Prada is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Arturo Prada is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 6002942232
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20100326000948
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
8 DME suppliers used 18 Medicare Claims 48 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Lancets, per box of 100 (HCPCS:A4259)
6 DME suppliers used 12 Medicare Claims 16 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Tape, non-waterproof, per 18 square inches (HCPCS:A4450)
1 DME suppliers used 11 Medicare Claims 4320 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing (HCPCS:A6252)
1 DME suppliers used 12 Medicare Claims 1080 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6402)
1 DME suppliers used 11 Medicare Claims 2160 Services Paid
DME-Other DME (DE017N)
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)
2 DME suppliers used 17 Medicare Claims 17 Services Paid
Unknown
Treatment-Treatment - Miscellaneous (RX029N)
Azathioprine, oral, 50 mg (HCPCS:J7500)
1 DME suppliers used 12 Medicare Claims 720 Services Paid
Treatment-Treatment - Miscellaneous (RX029N)
Tacrolimus, immediate release, oral, 1 mg (HCPCS:J7507)
1 DME suppliers used 12 Medicare Claims 1440 Services Paid
Treatment-Chemotherapy (RH012N)
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period (HCPCS:Q0512)
1 DME suppliers used 13 Medicare Claims 14 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Administration of influenza virus vaccine
Annual depression screening, 15 minutes
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Hospital discharge day management, more than 30 minutes
Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage
Initial hospital inpatient care per day, typically 70 minutes
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
Transitional care management services for problem of moderate complexity
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
This service was performed 53 times for 52 patientsAn annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
This service was performed 79 times for 79 patientsAn annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
This service was performed 59 times for 59 patientsThis 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.
This service was performed 140 times for 103 patientsThis 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.
This service was performed 379 times for 177 patientsFollow-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.
This service was performed 117 times for 23 patientsFollow-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.
This service was performed 604 times for 34 patientsHospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
This service was performed 58 times for 32 patientsThe quadrivalent inactivated influenza vaccine is a shot given to protect against four strains of the flu virus. This 0.5 ml dosage helps your body develop immunity to the virus. It's an important step in preventing flu-related complications.
This service was performed 53 times for 52 patientsInitial 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.
This service was performed 96 times for 41 patientsAn electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
This service was performed 95 times for 91 patientsTransitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.
This service was performed 15 times for 15 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $33.57 for a new patient copayment and $25.58 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 48306 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $134.28
- Minimum New Patient Price $58.04
- Maximum New Patient Price $177.36
- Average New Patient Copayment $33.57
- Minimum New Patient Copayment $14.51
- Maximum New Patient Copayment $44.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $102.35
- Minimum Established Patient Price $18.32
- Maximum Established Patient Price $143.49
- Average Established Patient Copayment $25.58
- Minimum Established Patient Copayment $4.58
- Maximum Established Patient Copayment $35.87
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse) | 84% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 38 |
| Percentage of patients, aged 18 years and older, with a diagnosis of acute viral sinusitis who were prescribed an antibiotic within 10 days after onset of symptoms | ||
| Care Plan | 82% | 481 |
| 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 or provide an advance care plan | ||
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| Colorectal Cancer Screening | 78% | 469 |
| Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
| Diabetes: Eye Exam | 71% | 157 |
| Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period | ||
| e-Prescribing | 90% | 8400 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Health Information Exchange | 77% | 392 |
| The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral. | ||
| Immunization Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data. | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Medication Reconciliation | 98% | 178 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Patient-Specific Education | 98% | 851 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 100% | 290 |
| 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 twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Preventive Care and Screening: Influenza Immunization | 65% | 860 |
| Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization | ||
| Provide Patient Access | 68% | 851 |
| 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 certain information. | ||
| Secure Messaging | 55% | 851 |
| 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 message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Arturo Prada is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| ASCENSION PROVIDENCE ROCHESTER HOSPITAL | 1101 W UNIVERSITY DRIVE ROCHESTER, MI 48307 | (248) 652-5000 | Acute Care Hospitals | |
| BEAUMONT HOSPITAL, TROY | 44201 DEQUINDRE ROAD TROY, MI 48085 | (248) 964-8800 | Acute Care Hospitals |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 23D0371422
- Facility Type
- Physician Office
- Certificate Effective Date
- December 23, 2023
- Certificate Expiration Date
- December 22, 2025
- Laboratory Director
- ARTURO PRADA
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Arturo Prada to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 2 | 7 | 0 | 3 | 0 | 1 | 4 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 4 | 7 | 0 | 3 | 0 | 1 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 4 + 7 + 0 + 3 + 0 + 1 + 8 + 24 = 53 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 53 = 7 | 7 | ||||||||
The NPI number 1427030147 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 19 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1538227244 | RICHARDS & RICHARDSON, P.C. Organization | Family Medicine | 6700 N ROCHESTER RD SUITE 100 ROCHESTER HILLS, MI 48306 (248) 650-1520 |
| 1124159231 | NORTH OAKLAND DERMATOLOGY PC Organization | Specialist | 6700 N ROCHESTER RD SUITE 212 ROCHESTER HILLS, MI 48306 (248) 650-1510 |
| 1891980884 | NUTRITION EMPHAIS CENTER, PLLC Organization | Clinic/Center (Medical Specialty) | 6700 N ROCHESTER RD SUITE 110 ROCHESTER HILLS, MI 48306 (248) 652-1202 |
| 1013183458 | ARTURO PRADA, M.D., P.C. Organization | Internal Medicine | 6700 N ROCHESTER RD SUITE 110 ROCHESTER HILLS, MI 48306 (248) 652-1202 |
| 1568520252 | MR. STEPHEN RANDOLPH RICHARDSON D.O. Individual | Family Medicine | 6700 N ROCHESTER RD SUITE 100 ROCHESTER HILLS, MI 48306 (248) 650-1520 |
| 1548328321 | MISS STACY KATHLEEN RICHARDS M.D. Individual | Family Medicine | 6700 N ROCHESTER RD SUITE 100 ROCHESTER HILLS, MI 48306 (248) 650-1520 |
| 1942452677 | MRS. ANDREA LEE DREFFS PA-C Individual | Physician Assistant | 6700 N ROCHESTER RD SUITE 212 ROCHESTER HILLS, MI 48306 (248) 650-1510 |
| 1790990471 | ROBERT H CORNFIELD DPM PC Organization | Podiatrist (Foot & Ankle Surgery) | 6700 N ROCHESTER RD SUITE 112 ROCHESTER HILLS, MI 48306 (248) 364-0500 |
| 1689024028 | MEGAN HENAHAN Individual | Specialist/Technologist (Athletic Trainer) | 6700 N ROCHESTER RD ROCHESTER HILLS, MI 48306 (248) 650-1520 |
| 1831690171 | MARK BOTTERILL Individual | Physical Therapist | 6700 N ROCHESTER RD ROCHESTER HILLS, MI 48306 (248) 650-1515 |
| 1487149126 | FMS ROCHESTER HILLS, LLC Organization | Clinic/Center (End-Stage Renal Disease (ESRD) Treatment) | 6700 N ROCHESTER RD ROCHESTER HILLS, MI 48306 (781) 699-9000 |
| 1093296204 | KIM MARIE WETHERHOLT RPH Individual | Pharmacist | 6700 N ROCHESTER RD ROCHESTER HILLS, MI 48306 (248) 601-1178 |
| 1457445850 | CLINICAL PHCY AND PHARM CARE CTR Organization | Pharmacy (Community/Retail Pharmacy) | 6700 N ROCHESTER RD STE 101 ROCHESTER HILLS, MI 48306 (248) 656-8131 |
| 1760417679 | DR. EVA L YOUSHOCK MD Individual | Dermatology | 6700 N ROCHESTER RD STE 212 ROCHESTER HILLS, MI 48306 (248) 650-1510 |
| 1598066219 | LAKSHMI PHARMACY ENTERPRISES LLC Organization | Pharmacy (Community/Retail Pharmacy) | 6700 N ROCHESTER RD SUITE 101 ROCHESTER HILLS, MI 48306 (248) 601-1178 |
| 1053874560 | ERICA ROSE JARCAIG MD Individual | Family Medicine | 6700 N ROCHESTER RD ROCHESTER HILLS, MI 48306 (248) 650-1520 |
| 1811483159 | FMS BEAUMONT HEALTH, LLC Organization | Clinic/Center (End-Stage Renal Disease (ESRD) Treatment) | 6700 N ROCHESTER RD ROCHESTER HILLS, MI 48306 (248) 650-3060 |
| 1851979769 | COLT JOSEPH MORAN MD Individual | Family Medicine | 6700 N ROCHESTER RD ROCHESTER HILLS, MI 48306 (248) 650-1520 |
| 1124827639 | SARAH GRACE AUSUM PT, DPT Individual | Physical Therapist | 6700 N ROCHESTER RD ROCHESTER HILLS, MI 48306 (248) 650-1515 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1427030147, enumerated in the NPI registry as an "individual" on November 17, 2005
The provider is located at 6700 N Rochester Rd Suite 110 Rochester Hills, Mi 48306 and the phone number is (248) 652-1202
The provider's speciality is Internal Medicine with taxonomy code 207R00000X
The provider has more than 56 years of experience.
The provider might be accepting Accepts: Ambetter from Meridian, Ambetter Health, Blue Care. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $134.28 with an average copayment of $33.57 for new patient appointments. Established patients should expect a typical charge of $102.35 and an average copayment of 25.58. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Administration of influenza virus vaccine, Annual depression screening, 15 minutes, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Established patient office or other outpatient visit, 30-39 minutes, Established patient office or other outpatient visit, 40-54 minutes, Follow-up hospital inpatient care per day, typically 25 minutes, Follow-up hospital inpatient care per day, typically 35 minutes, Hospital discharge day management, more than 30 minutes, Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage, Initial hospital inpatient care per day, typically 70 minutes, Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report and Transitional care management services for problem of moderate complexity.
The provider's CLIA number is 23D0371422 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
The practitioner is affiliated to the following hospital(s): ASCENSION PROVIDENCE ROCHESTER HOSPITAL and BEAUMONT HOSPITAL, TROY. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on November 17, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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