Individual provider Active NPI

Haylee Prochaska

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1740032465
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
179 Longwood Ave
Boston, MA 02115-5804
Phone
(617) 732-2918
NPI assigned
Apr 4, 2024
Last updated
Apr 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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 NU Primary

Addresses

Primary practice location

179 Longwood Ave
Boston, MA 02115-5804

Mailing address

1088 Shady Pine LN SW
Montgomery, MN 56069-4134
Phone (612) 876-7141

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240910000902 MN Practitioner - Physician Assistant 0446790091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northfield HospitalGroup PAC ID 2567372998, 121 clinicians

Practice addresses (Care Compare)

2000 N a Ve
Northfieldm, MN 55057-1498

2000 N Ave
Northfield, MN 55057-1498
Phone (507) 646-1478

2014 Jefferson Rd
Suite C
Northfield, MN 55057-3251
Phone (507) 646-6700

4645 Knutsen Dr
Farmington, MN 55024-8455
Phone (651) 460-2300

9974 214TH St W
Lakeville, MN 55044-1913
Phone (952) 469-0500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northfield Hospital CurrentSince Jun 28, 2024 Accepting new patients
Northfield Hospital CurrentSince Jun 28, 2024 Accepting new patients
Northfield Hospital Past Accepting new patients
Northfield Hospital Past Accepting new patients
Northfield Hospital Past Accepting new patients
Northfield Hospital Past Accepting new patients
Northfield Hospital Past Accepting new patients

Locations

4645 Knutsen Dr
Farmington, MN 55024
Phone (651) 460-2300

2000 North Ave
Northfield, MN 55057
Phone (507) 646-1000

2014 Jefferson Rd
Northfield, MN 55057
Phone (507) 664-9999

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1712188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1740032465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1088 SHADY PINE LN SW",
            "city": "MONTGOMERY",
            "state": "MN",
            "postal_code": "560694134",
            "telephone_number": "612-876-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155804",
            "telephone_number": "617-732-2918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCHASKA",
        "first_name": "HAYLEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.