Individual provider Active NPI

Terasa Louise Prock, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Kalispell, MT
National Provider Identifier
1528288974
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
MED-PHYS-LIC-99776 Issued in MT
Practice address
310 Sunnyview LN
Kalispell, MT 59901-3129
Phone
(406) 751-6725
Fax
(406) 758-5170
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MED-PHYS-LIC-99776 MT
Critical Care Medicine (Internal Medicine) Physician 207RC0200X DR55865 CO
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X MED-PHYS-LIC-99776 MT Primary

Addresses

Primary practice location

310 Sunnyview LN
Kalispell, MT 59901-3129

Mailing address

310 Sunnyview LN
Kalispell, MT 59901-3129
Phone (406) 751-6725

Other practice location 1

350 Heritage Way Ste 2100
Kalispell, MT 59901-3167
Phone (406) 751-6725

Other identifiers 1

IdentifierTypeStateIssuer
311325OtherCOIM

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address krmcmedicalrecords@krhdirect.org Kalispell Regional Medical Center Inc
Direct Messaging Address krmcmedicalrecords@krhdirect.org Kalispell Regional Medical Center Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20121004000315 NM Practitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 2062661119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Critical Care (Intensivists)
Education
Texas a & M University System, HSC, College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone (505) 841-1234

2200 W 21St St
Clovis, NM 88101-2011
Phone (505) 769-7577

2400 Unser Blvd SE
Rio Rancho, NM 87124-3392

2400 Unser Blvd SE
Rio Rancho, NM 87124-4740

PO Box
Albuquerque, NM 87125-6666

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
54.81 of 100Reported as group
Quality
22.51
Promoting interoperability
100
Improvement activities
0
Cost
76.87

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR55865COMDCritical Care Medicine (Internal Medicine) Physician
MED-PHYS-LIC-99776MTMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Jan 30, 2024 Accepting new patients
Presbyterian Healthcare Services CurrentSince Jan 30, 2024 Accepting new patients

Locations

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

Interoperability endpoints

  • Direct secure messaging: tprock244886@direct.phs.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1528288974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 SUNNYVIEW LN",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013129",
            "telephone_number": "406-751-6725",
            "fax_number": "406-758-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 SUNNYVIEW LN",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013129",
            "telephone_number": "406-751-6725",
            "fax_number": "406-758-5170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Heritage Way Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013167",
            "country_code": "US",
            "telephone_number": "406-751-6725",
            "fax_number": "406-758-5170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROCK",
        "first_name": "TERASA",
        "middle_name": "LOUISE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MT",
            "license": "MED-PHYS-LIC-99776",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CO",
            "license": "DR55865",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "MT",
            "license": "MED-PHYS-LIC-99776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IM",
            "identifier": "311325",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "310 Sunnyview Ln",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "350 Heritage Way Ste 2100",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.