P Praxis·MD
Taxonomy 302F00000X

Exclusive Provider Organization

There are 2274 active exclusive provider organization providers in the United States, distributed across 56 states. (1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is

By state

Top metros

About exclusive provider organization

(1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations.

Frequently asked

What does a exclusive provider organization provider do?

Exclusive Provider Organization providers are healthcare professionals classified under the NUCC Healthcare Provider Taxonomy. Refer to the NUCC taxonomy definitions and your state licensing board for scope of practice details.

How do I verify a exclusive provider organization provider's NPI?

Every NPI on Praxis MD has a verifiable record in the official CMS NPPES registry. Open NPPES to confirm, then check the issuing state board for current license status.

How current is this data?

Praxis MD refreshes the monthly NPPES bulk file and applies weekly delta updates. Each page shows its 'Updated' date.

Provyx · Custom healthcare lists

Need this list at scale?

Request a quote →