Derek Evan Prowe, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP5238 Issued in MN

Practice address

4749 Chicago Ave Ste 1D
Minneapolis, MN 55407-4181

Phone

(612) 656-9122

NPI assigned

Sep 15, 2008

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: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Derek Prowe LLC

  • Psychologist
  • Minneapolis, MN
  • NPI 1083074371
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1699924639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4749 CHICAGO AVE STE 1D",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554074181",
            "telephone_number": "612-656-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4749 CHICAGO AVE STE 1D",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554074181",
            "telephone_number": "612-656-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROWE",
        "first_name": "DEREK",
        "middle_name": "EVAN",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-15",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP5238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nefeli Protogeraki
• Marina Proudfoot, D.C.
• Kirsten Kay Prouty, OTR/L
• Provenance Homes 1, LLC
• Providence 99:1
• Julie Ann Prowe
• Tamulus Prowell
• Heather Heiligman Prudden, MSW, L.I.C.S.W.
• Prudential Homecare LLC
• Melissa M Prudhomme, LADC

• Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; 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.