DR. JOHN W PRUITT (D.D.S., M.D.) – Oral and Maxillofacial Surgery (Dentist), NPI 1821045147
Oral and Maxillofacial Surgery (Dentist)
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
34 MAXILLOFACIAL SURGERY in IN
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Provider Addresses for DR. JOHN W PRUITT (D.D.S., M.D.)
Indiana Oral & Maxillofacial Surgery Associates, 10972, Allisonville Road, Fishers, Hamilton County, Indiana, 46038, United States of America
SUITE 110
FISHERS, IN 460382637
Phone: (317) 913-2363
Fax: (317) 913-2360
Type: Mailing
1630, West Smith Valley Road, Green Valley, Greenwood, Johnson County, Indiana, 46142, United States
GREENWOOD, IN 461421550
Phone: (317) 882-3370
Fax: (317) 882-2964
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-08-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100820000682 | I | Maxillofacial Surgery | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99202 | New patient office or other outpatient visit, 15-29 minutes | 24 | 24 | $0 |
Insurance plans in this area (ZIP 46038)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Maxillofacial Surgery, Oral Surgery | IN | |
| Oral Surgery, Maxillofacial Surgery | IN | |
| - | IN | |
| Maxillofacial Surgery, Oral Surgery | IN | |
| Maxillofacial Surgery, Oral Surgery | IN | |
| Maxillofacial Surgery, Oral Surgery | IN | |
| Maxillofacial Surgery | IN | |
| Maxillofacial Surgery | IN | |
| - | IN | |
| - | IN |
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