Organization Active NPI

Pain Care Professionals, Inc.

  • Pain Medicine (Anesthesiology) Physician
  • Philadelphia, PA
National Provider Identifier
1689666315
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
PAIN CARE PROFESSIONALS, INC.
Practice address
Hahnemann University Hospital Pain Clinic
Broad & Vine St., 4TH Floor South Tower
Philadelphia, PA 19096
Phone
(610) 795-7375
Fax
(610) 795-7376
NPI assigned
Aug 18, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Wes Prokop, M.D.
Title
President
Phone
(610) 642-3527

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

Hahnemann University Hospital Pain Clinic
Broad & Vine St., 4TH Floor South Tower
Philadelphia, PA 19096

Mailing address

PO Box 237
Wynnewood, PA 19096-0237
Phone (610) 642-3527

Other names 1

  • Pain Care Group, Inc. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050503001133 PA Part B Supplier - Clinic/Group Practice 8325088958 Receives reassigned benefits from 1 practitioner
Practice locations: Bala Cynwyd, PA; Philadelphia, PA
O20110601000248 NJ Part B Supplier - Clinic/Group Practice 8325088958 Receives reassigned benefits from 1 practitioner
Practice locations: Voorhees, NJ

National Provider Directory

National Provider Directory

Locations

2301 E Evesham Rd
Ste 408
Voorhees, NJ 08043
Phone (610) 888-1839

15 Presidential Blvd
Ste 100
Bala Cynwyd, PA 19004
Phone (215) 762-7246

600 E Township Line Rd
Ste 1
Havertown, PA 19083
Phone (610) 789-0888

230 N Broad St
Fl 4
Philadelphia, PA 19102
Phone (215) 762-1738

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689666315",
    "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": "610-642-3527",
            "fax_number": "610-795-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HAHNEMANN UNIVERSITY HOSPITAL PAIN CLINIC",
            "address_2": "BROAD & VINE ST., 4TH FLOOR SOUTH TOWER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19096",
            "telephone_number": "610-795-7375",
            "fax_number": "610-795-7376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CARE PROFESSIONALS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PROKOP",
        "authorized_official_first_name": "WES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-642-3527",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pain Care Group, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.