Active NPI
Jennifer Manko Prohow, D.O.
- Family Medicine Physician
- Lake Orion, MI
National Provider Identifier
1750418059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 5101015830
- Practice address
- 1455 S Lapeer Rd
Suite 100
Lake Orion, MI 48360-1467 - Phone
- (248) 693-3551
- Fax
- (248) 693-4643
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101015830 | MI | Primary |
Addresses
Primary practice location
1455 S Lapeer Rd
Suite 100
Lake Orion, MI 48360-1467
Mailing address
3099 Brookside Dr
Waterford, MI 48328-2595
Phone (248) 681-5890
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080821000541 | MI | Practitioner - Family Practice | 1355416587 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Orion Family Physicians PC
Practice addresses (Care Compare)
1455 S Lapeer Rd
Suite 100
Lake Orion, MI 48360-1468
Phone (248) 693-3551
Hospital & facility affiliations
- Beaumont Hospital, Troy
- Beaumont Hospital Royal Oak
- Beaumont Hospital - Farmington Hills
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101015830 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orion Family Physicians PC | Family Medicine | Current | Accepting new patients |
Locations
1455 S Lapeer Rd
Ste 100
Lake Orion, MI 48360
Phone (248) 693-3551
Interoperability endpoints
- jenniferprohow@ofp.allscriptsdirect.net
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Lake Orion, MI
- NPI 1578627816
Family Medicine, MI
Hospital & facility affiliations 11
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": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750418059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3099 BROOKSIDE DR",
"city": "WATERFORD",
"state": "MI",
"postal_code": "483282595",
"telephone_number": "248-681-5890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1455 S LAPEER RD",
"address_2": "SUITE 100",
"city": "LAKE ORION",
"state": "MI",
"postal_code": "483601467",
"telephone_number": "248-693-3551",
"fax_number": "248-693-4643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROHOW",
"first_name": "JENNIFER",
"middle_name": "MANKO",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "5101015830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Orion, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.