Individual provider Active NPI

Craig P Prokos, M.D.

  • Internal Medicine Physician
  • Jupiter, FL
National Provider Identifier
1205838166
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101280175 Issued in VA
Practice address
136 Jupiter Lakes Blvd
Jupiter, FL 33458-7180
Phone
(561) 746-3030
Fax
(561) 746-0771
NPI assigned
Aug 11, 2005
Reactivated
Mar 31, 2006
Last updated
Oct 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME32958 FL
Internal Medicine Physician 207R00000X 0101280175 VA Primary

Addresses

Primary practice location

136 Jupiter Lakes Blvd
Jupiter, FL 33458-7180

Mailing address

136 Jupiter Lakes Blvd
Jupiter, FL 33458-7180
Phone (561) 746-3030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VA2 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

Enrollment IDStateProvider typePAC IDDetails
I20101129000178 FL Practitioner - Internal Medicine 6709072044 Practice locations: Jupiter, FL
I20250805003103 VA Practitioner - Internal Medicine 6709072044 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pai Participant 1 LLCGroup PAC ID 8123351954, 174 clinicians
Universal Health CorporationGroup PAC ID 5597912626, 120 clinicians

Practice addresses (Care Compare)

1945 Roanoke Blvd
Salem, VA 24153-6408
Phone (540) 345-3894

200 Weaver Ave
Emporia, VA 23847-1230
Phone (540) 814-5344

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pai Participant 1 LLC CurrentSince Jul 18, 2025 Accepting new patients
Universal Health Corporation Internal Medicine CurrentSince Jul 21, 2025 Accepting new patients
Craig P. Prokos, M.D. Internal Medicine PastSince Feb 8, 2001 Accepting new patients

Locations

5539 Highway Forty Seven
Chase City, VA 23924
Phone (434) 372-4063

200 Weaver Ave
Emporia, VA 23847
Phone (434) 634-6581

1475 Virginia Ave
Harrisonburg, VA 22802
Phone (540) 564-3400

130 Church Ave SW
Roanoke, VA 24011

1945 Roanoke Blvd
Salem, VA 24153
Phone (540) 345-3094

Organizations & group practices 4

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1205838166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 JUPITER LAKES BLVD",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587180",
            "telephone_number": "561-746-3030",
            "fax_number": "561-746-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 JUPITER LAKES BLVD",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587180",
            "telephone_number": "561-746-3030",
            "fax_number": "561-746-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROKOS",
        "first_name": "CRAIG",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "deactivation_date": "2006-03-22",
        "reactivation_date": "2006-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME32958",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101280175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

Verify at the official NPI Registry.