Active NPI
Logan Prock
- Physician Assistant
- Washington, DC
National Provider Identifier
1811739121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 5255 Loughboro Rd NW
Washington, DC 20016-2633 - Phone
- (202) 537-4000
- NPI assigned
- Jun 7, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
5255 Loughboro Rd NW
Washington, DC 20016-2633
Mailing address
53 Redhawk
Irvine, CA 92604-3248
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
5215 Loughboro Rd NW
Suite 510
Washington, DC 20016-2628
Phone 20296663005
6410 Rockledge Dr
Suite 600
Bethesda, MD 20817-1844
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Interoperability endpoints
- lprock1169210@direct.hopkinsmedicine.org
Organizations & group practices 2
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.
-
- Specialist
- Washington, DC
- NPI 1770772816
-
- Rehabilitation Clinic/Center
- Bethesda, MD
- NPI 1457354748
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Washington, DC
- NPI 1366492977
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717718400000",
"number": "1811739121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53 REDHAWK",
"city": "IRVINE",
"state": "CA",
"postal_code": "926043248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5255 LOUGHBORO RD NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200162633",
"telephone_number": "202-537-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCK",
"first_name": "LOGAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-07",
"last_updated": "2024-06-07",
"certification_date": "2024-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.