Wieslaw K. Prokop, M.D.

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

MD419479 Issued in PA

Practice address

15 Presidential Blvd
Suite 100
Bala Cynwyd, PA 19004-1000

Phone

(610) 795-7366

Fax

(610) 664-4749

NPI assigned

Aug 18, 2005

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

Other names 1

• Dr. Wes Prokop Other name

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 enrollments

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 2

Specialty

AnesthesiologyAlso: Interventional Pain Management, Pain Management

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Pain Care Professionals, Inc.

  • Pain Medicine (Anesthesiology) Physician
  • Philadelphia, PA
  • NPI 1689666315

  NJ

  Medicare reassignment
• Philadelphia Health & Education Corporation

  • Gynecologic Oncology Physician
  • Philadelphia, PA
  • NPI 1356496038
  NPD (past)
• TPS II of PA, LLC

  • Anesthesiology Physician
  • Phila, PA
  • NPI 1114975869
  NPD (past)

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1144212879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 237",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190960237",
            "telephone_number": "610-795-7366",
            "fax_number": "610-664-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PRESIDENTIAL BLVD",
            "address_2": "SUITE 100",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041000",
            "telephone_number": "610-795-7366",
            "fax_number": "610-664-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROKOP",
        "first_name": "WIESLAW",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "PA",
            "license": "MD419479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19053230001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WES",
            "last_name": "PROKOP",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Margaret Ann Price, MD
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• Pro Support Systems
• Michael J Pro, MD
• Professional Psychology Group
• Prosthetic Beauty Solutions
• Loren Pruitt
• Danielle Emily Psillos, PSYD
• Q Psych Assessment
• Q Psychological & Consultation Services PLLC

• Pain Medicine (Anesthesiology) Physician in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Pain Medicine (Anesthesiology) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.