Kristin Marie Prochaska, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1000130 Issued in NC

Practice address

128 Medical Park Rd Ste 201
Mooresville, NC 28117-8579

Phone

(704) 235-1827

Fax

(704) 235-1823

NPI assigned

Dec 21, 2005

Last updated

Apr 25, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Healthcare PAGroup PAC ID 9638070683, 226 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Piedmont Healthcare, P.a.

  • Internal Medicine Physician
  • Statesville, NC
  • NPI 1912999897
  Medicare reassignment Care Compare group NPD
• Piedmont Healthcare, PA

  • Durable Medical Equipment & Medical Supplies
  • Statesville, NC
  • NPI 1639041320
  NPD
• Dermatology Consultants of S FL PA

  • Dermatology Physician
  • Coral Springs, FL
  • NPI 1629186523
  NPD (past)
• Skin and Cancer Associates

  • Dermatology Physician
  • Plantation, FL
  • NPI 1427017292
  NPD (past)

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1902882988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845",
            "telephone_number": "704-235-1827",
            "fax_number": "704-235-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 MEDICAL PARK RD STE 201",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178579",
            "telephone_number": "704-235-1827",
            "fax_number": "704-235-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCHASKA",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-21",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "1000130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Presbyterian Imaging Centers LLC (Novant Health Breast Imaging Center Langtree)
• Simone Presley
• Justin M Pretzel, DPT
• Aaron Price
• Bre Bailey Price, MS, CCC-SLP
• Professional Pharmacy Concepts
• Prosperity Path, LLC
• Psychological Solutions of Lake Norman, PLLC
• Publix North Carolina LP (Publix Pharmacy #1519)
• Publix North Carolina, LP (Publix Pharmacy #1872)

• Physician Assistant in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2018; 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.