Individual provider Active NPI

Nicholas Prosper, PA-C

  • Physician Assistant
  • Stroudsburg, PA
National Provider Identifier
1710617071
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
100 St Lukes LN
Stroudsburg, PA 18360-6217
Phone
(866) 785-8537
NPI assigned
Jun 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

100 St Lukes LN
Stroudsburg, PA 18360-6217

Mailing address

516 Jenna Dr
Brodheadsville, PA 18322-7141
Phone (272) 212-4000

Other practice location 1

516 Jenna Dr
Brodheadsville, PA 18322-7141
Phone (272) 212-4000

Other practice location 2

235 E Brown St Ste 302
East Stroudsburg, PA 18301-3013
Phone (272) 212-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220912002382 PA Practitioner - Physician Assistant 6204211220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

100 St Lukes LN
Stroudsburg, PA 18360-6217
Phone (484) 526-2200

100 St Lukes Way
Stroudsburg, PA 18360-6217
Phone (272) 212-1000

235 E Brown St
Stroudsburg, PA 18301-3013
Phone (570) 645-1830

516 Jenna Dr
Brodheadsville, PA 18322-7141
Phone (272) 212-4000

801 Ostrm St
Bethlehem, PA 18015-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Physician Group Inc CurrentSince Sep 26, 2022 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Sep 26, 2022 Accepting new patients
St. Luke's Physician Group, Inc Past Accepting new patients

Locations

516 Jenna Dr
Brodheadsville, PA 18322
Phone (272) 212-4000

235 E Brown St
Ste 302
East Stroudsburg, PA 18301
Phone (272) 212-4000

235 E Brown St
Fl 101
East Stroudsburg, PA 18301
Phone (272) 212-4000

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

1241 Blakeslee Boulevard Dr E
Ste 3
Lehighton, PA 18235
Phone (570) 386-6900

100 St Lukes Ln
Stroudsburg, PA 18360
Phone (272) 212-1000

17 W Broad St
Unit 2
Tamaqua, PA 18252
Phone (570) 668-5650

17 W Broad St
Unit 3
Tamaqua, PA 18252
Phone (570) 668-5650

Interoperability endpoints

  • Direct secure messaging: nicholas.prosper@slpg.direct-sluhn.org

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1710617071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 JENNA DR",
            "city": "BRODHEADSVILLE",
            "state": "PA",
            "postal_code": "183227141",
            "telephone_number": "272-212-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ST LUKES LN",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183606217",
            "telephone_number": "866-785-8537"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "516 Jenna Dr",
            "address_purpose": "LOCATION",
            "city": "Brodheadsville",
            "state": "PA",
            "postal_code": "183227141",
            "country_code": "US",
            "telephone_number": "272-212-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "235 E Brown St Ste 302",
            "address_purpose": "LOCATION",
            "city": "East Stroudsburg",
            "state": "PA",
            "postal_code": "183013013",
            "country_code": "US",
            "telephone_number": "272-212-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROSPER",
        "first_name": "NICHOLAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroudsburg, PA

Sources for this page

Verify at the official NPI Registry.