Oto Prokop, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD15742 Issued in ME

Practice address

46 Fairview Ave Ste 111
Skowhegan, ME 04976-1481

Phone

(207) 474-0905

Fax

(207) 474-6930

NPI assigned

Jul 16, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: oto.prokop@rmpc.direct.rfgh.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Redington-Fairview General Hospital

  • Critical Access Hospital
  • Skowhegan, ME
  • NPI 1174549133
  Medicare reassignment NPD
• Redington-Fairview General Hospital

  • Rural Health Clinic/Center
  • Madison, ME
  • NPI 1851423008
  NPD
• University of South Alabama Health Services Foundation

  • Clinical Medical Laboratory
  • Mobile, AL
  • NPI 1548357916
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1083631014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 468",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049760468",
            "telephone_number": "207-474-0905",
            "fax_number": "207-474-6930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 FAIRVIEW AVE STE 111",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049761481",
            "telephone_number": "207-474-0905",
            "fax_number": "207-474-6930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROKOP",
        "first_name": "OTO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD15742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083631014",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Ashley Poissonnier
• Nathan Pomelow
• Nathaniel J Powers, PHARMD
• Jason M Prada, DPT
• Melody Lynn Pratt, DO
• Leah Marie Provost, PMHNP-BC
• Celeste Cheryll Lopez Quianzon, MD
• Florello Sven-Erik M Quianzon, MD
• Anna Quirion, R.N.
• Rachelle Nunn

• Internal Medicine Physician in Skowhegan, ME
• Providers in Skowhegan, ME by specialty
• Internal Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.