Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ethan A Prairie, MD

Individual provider Family Medicine Physician · NPI 1134749195

Ethan A Prairie, MD is a Family Practice in Rio Rancho, New Mexico. Graduated from University of New Mexico School of Medicine in 2020, 6 years ago. Practices with Presbyterian Healthcare Services, a 1,375-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New Mexico.

Years since qualifying
6
Trained at
University of New Mexico School of Medicine
Licensed in
NM
In the registry since
2020
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4005 High Resort Blvd SE
Rio Rancho, NM 87124-5906
Phone: (505) 462-6000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD2023-0538 (NM)

Record details

NPI number1134749195
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 20, 2020
Last updated in NPPESDecember 29, 2023
Certification dateDecember 29, 2023
Mailing address4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE
Graduated 2020 (6 years in practice)
Group practice Presbyterian Healthcare Services — 1375 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Rio Rancho