Jason Michael Prostrollo, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

57872 Issued in MN

Practice address

1835 County Road C W
Roseville, MN 55113-1352

Phone

(763) 785-4300

Fax

(763) 785-7779

NPI assigned

Jul 11, 2011

Last updated

Sep 30, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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 Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jprostrollo225491@excellian.direct.allina.com

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.

• Allina Health System

  dba Allina Health Annandale Clinic

  • Family Medicine Physician
  • Annandale, MN
  • NPI 1457657249
  Medicare reassignment NPD
• Allina Health System

  dba Allina Health Uptown Clinic

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1508162249
  NPD
• Allina Health System

  dba Allina Health TeleRheumatology

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1558659615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 COUNTY ROAD C W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131352",
            "telephone_number": "763-785-4300",
            "fax_number": "763-785-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 COUNTY ROAD C W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131352",
            "telephone_number": "763-785-4300",
            "fax_number": "763-785-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSTROLLO",
        "first_name": "JASON",
        "middle_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-11",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "57872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Primecare Assistants (Primecare Assistants LLC)
• Carrie Pritzl III
• Procare Home Assistance
• Progress Valley, Inc.
• Prosthodontic Associates, PLLC
• Public Health Dental LLC
• Bernadette Putman, CCC-SLP
• Rasha Qasim
• Quality Home Care LLC
• Mark E. Quandt, D.C.

• Pediatrics Physician in Roseville, MN
• Providers in Roseville, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.