DEREK PROWE LLC
NPI 1083074371
Psychologist in Minneapolis, MN

Active since February 29, 2016
4749 CHICAGO AVE, SUITE 1D, MINNEAPOLIS, MN 55407(612) 656-9122 Get Directions Write a Review

NPPES record last updated: February 29, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Derek Prowe Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEREK PROWE LLC (NPI 1083074371) is a healthcare organization registered as a psychologist in Minneapolis, Minnesota and active in the NPI registry since February 2016. The organization lists Derek Evan Prowe, Owner, as its authorized official.

NPPES Registry Identity

NPI1083074371
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameDEREK PROWE LLC
Location Address4749 CHICAGO AVE, SUITE 1DMinneapolis, MN 55407-3556
Mailing Address4749 Chicago Ave, Suite 1dMinneapolis, MN 55407-3556 · (612) 656-9122
Organization SubpartNo
Authorized OfficialDerek Evan ProweOwner · (612) 656-9122
Enumeration DateFebruary 29, 2016
✔ NPI 1083074371 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in MN · LP5238
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
4749 CHICAGO AVE, Minneapolis, MN 55407

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Derek Prowe Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Derek Prowe LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Clinical Psychologist
NPI 1699924639
4749 CHICAGO AVE STE 1D
Minneapolis, MN 55407
(612) 656-9122
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derek Prowe LLC's NPI number?

The NPI number for Derek Prowe LLC is 1083074371. It was assigned to this organization in the NPPES registry on February 29, 2016.

Where is Derek Prowe LLC located?

Derek Prowe LLC is located at 4749 Chicago Ave Suite 1D, Minneapolis, MN 55407. The listed phone number is (612) 656-9122.

What is Derek Prowe LLC's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Derek Prowe LLC enrolled in Medicare?

Yes. Derek Prowe LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Derek Prowe LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Derek Prowe LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Derek Prowe LLC accept?

Health plans from HealthPartners list Derek Prowe LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Derek Prowe LLC was last updated on February 29, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.