Progressed Medical Professional Corporation

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PROGRESSED MEDICAL PROFESSIONAL CORPORATION

Practice address

68 S Service Rd Ste 100
Melville, NY 11747-2350

Phone

(646) 895-1174

NPI assigned

Dec 23, 2022

Last updated

Mar 6, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bo HeadlamNPI 1619939246

Title

Founder

Phone

(646) 895-1174

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bo Tyler Headlam, M.D.

  • Interventional Pain Medicine Physician
  • Portsmouth, OH
  • NPI 1619939246

  NY

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1671753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741219200000",
    "number": "1851003636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 S SERVICE RD STE 100",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472350",
            "telephone_number": "646-895-1174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 S SERVICE RD STE 100",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472350",
            "telephone_number": "646-895-1174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 W 42nd St Apt 50P",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100366885",
            "country_code": "US",
            "telephone_number": "646-895-1174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROGRESSED MEDICAL PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-23",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A",
        "authorized_official_last_name": "HEADLAM",
        "authorized_official_first_name": "BO",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "646-895-1174"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert L Prochnow, LCSW-R
• Professional Occupational & Physical Therapy, PLLC
• Professional Occupational & Physical Therapy, PLLC
• Professional Orthopedic and Sports Physical Therapy PC
• Carmina Marie Profeta
• Promed Preferred Az 2 PLLC (Wound Masters)
• Promed Preferred Mo P.C.
• Promed Preferred NJ 5 PC
• Proscripts LLC
• Prosthetics in Motion Melville, LLC

• Primary Care Clinic/Center in Melville, NY
• Providers in Melville, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.