DR. ROGER DEVERN PRUITT (D.O.) – Pediatrics Physician, NPI 1932104353

DR. ROGER DEVERN PRUITT (D.O.) is a healthcare provider. based in Wimberley, Texas. specializing in Pediatrics Physician. They hold the professional credentials D.O.. They hold a License No. L1706 (TX). The NPI Number for DR. ROGER DEVERN PRUITT (D.O.) is 1932104353

Main info

Male
Name
DR. ROGER DEVERN PRUITT (D.O.)
NPI
1932104353
Phone
(512) 847-7700
Address
180 JOE WIMBERLEY BLVD
Enumeration Date
14 June 2005
Last Update Date
9 February 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for DR. ROGER DEVERN PRUITT (D.O.)

  • 180, Joe Wimberley Boulevard, Wimberley, Hays County, Texas, 78676, United States

    STE 102

    WIMBERLEY, TX 786766083

    Phone: (512) 847-7700

    Fax: (512) 847-7701

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 9 Open Payments records for all available years, with a total value of $196.

Total Amount is formed as General ($196) + Research ($0) + Ownership ($0) = $196.

Last reported payment date: 2024-06-02 • Largest payer in this snapshot: Supernus Pharmaceuticals, Inc. ($68).

Total Amount

$196

General + Research + Ownership

Payments

9

Total payment records

General Amount

$196

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-02

Latest reported date

Top Companies

Largest payers in this snapshot

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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: 2021-09-02

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210902000557IPediatric MedicineTXTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 78676)

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Reviews

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Frequently asked questions

How do I look up DR. ROGER DEVERN PRUITT (D.O.) by NPI?
Use NPI 1932104353 when you need to reference DR. ROGER DEVERN PRUITT (D.O.) in forms, claims, or directories.
Is DR. ROGER DEVERN PRUITT (D.O.)'s NPI currently valid?
The extract we use shows DR. ROGER DEVERN PRUITT (D.O.) as active.
What does DR. ROGER DEVERN PRUITT (D.O.) treat or focus on?
Patients typically see DR. ROGER DEVERN PRUITT (D.O.) under the specialty Pediatrics Physician. Clinical services aligned with this taxonomy classification.
Where is DR. ROGER DEVERN PRUITT (D.O.)'s primary listing?
We display Wimberley, Texas because that is what the record indicates for DR. ROGER DEVERN PRUITT (D.O.).
Is DR. ROGER DEVERN PRUITT (D.O.) a real provider?
This page reflects official NPPES data for NPI 1932104353. Always confirm identity and privileges with the practice and licensing boards.

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