Tammy Lynn Prohofsky, APRN, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

7897 Issued in MN

Practice address

11000 Optum Cir
Eden Prairie, MN 55344-2503

Phone

(866) 686-2504

NPI assigned

Nov 4, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Tammy Perttula Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northern Lights Health LLCGroup PAC ID 6305278797, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adara Home Health Inc Home health agency, Buffalo, MN, CCN 248056

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

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.

• Northern Lights Health LLC

  • Primary Care Nurse Practitioner
  • Waconia, MN
  • NPI 1316581440
  Medicare reassignment Care Compare group NPD
• Waterside Healthcare & Wellness, LLC

  • Family Nurse Practitioner
  • Waconia, MN
  • NPI 1780223743
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adara Home Health, Inc.

  • Home Health Agency
  • Buffalo, MN
  • NPI 1063420198
  Care Compare affiliation

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1720689920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12490 FAIRBANKS AVE",
            "city": "LONSDALE",
            "state": "MN",
            "postal_code": "550464475",
            "telephone_number": "763-257-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11000 OPTUM CIR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553442503",
            "telephone_number": "866-686-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROHOFSKY",
        "first_name": "TAMMY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-04",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "7897",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R147035-4",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMMY",
            "last_name": "PERTTULA",
            "credential": "APRN, CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Prescription Drug Advocates LLC
• Pride Institute
• Nevaeh Priest
• Priority Home Care LLC
• Melanie Kay Proctor, PHARMD
• Allisa Prokopanko, MSW, LICSW
• Psi Pride Institute Inc
• Psychological Healthcare of Minnesota PA
• Hannah Lynn Pullen, RDN, LD
• Philip Punnoose, PT

• Nurse Practitioner in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.