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KRISTYN RENEE PROCKISH PMHNP
NPI 1164112827
Nurse Practitioner - Psychiatric/Mental Health in Bend, OR

Active since May 08, 2023PECOS Enrolled
62930 O B RILEY RD STE 200, BEND, OR 97703(541) 330-1919(833) 972-0672 Get Directions Write a Review

NPPES record last updated: September 22, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 3, 2024, May 8, 2023 (2 updates tracked since 2023).

About Kristyn Renee Prockish Pmhnp NPPES

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

KRISTYN RENEE PROCKISH PMHNP (NPI 1164112827) is an individual psychiatric/mental health provider in Bend, Oregon, licensed in Oregon (10008017) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Kirkland, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1164112827
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameKRISTYN RENEE PROCKISHCredential: PMHNP
Location Address62930 O B RILEY RD STE 200Bend, OR 97703-9459
Mailing Address399 E 10th AveEugene, OR 97401-3380
Phone(541) 330-1919
Fax(833) 972-0672
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMay 8, 2023
Last NPPES UpdateSeptember 22, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 22, 2025
✔ NPI 1164112827 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses✔ Licensed in OR · 10008017✔ Licensed in WA · AP70011033
62930 O B RILEY RD STE 200, Bend, OR 97703
Open in Google Maps ↗

Secondary Practice Location 1

Location 112025 115th Ave NE Ste 200Kirkland, WA 98034-6935 · Phone (425) 821-1810

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kristyn Renee Prockish Pmhnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6002341104
PECOS Enrollment IDI20251007003007
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kristyn Prockish reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Optum Behavioral Care Of Colorado, P.C.
88 mi
Clinical
101 E BROADWAY STE 400
Eugene, OR 97401
  • Reassigned Medicare billing, Oregon enrollment
  • Medicare enrollment name: Optum Behavioral Care Of Colorado PC
  • 44 clinicians in this Medicare group
NPI 1316717747 (704) 506-6267

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97703 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.82 typical visit price
range $54.96 – $166.64
Typical copayment $21.20 (range $13.74 – $41.66)
Most-billed visit code 99203
Established Patient
$97.16 typical visit price
range $17.68 – $136.19
Typical copayment $24.29 (range $4.42 – $34.04)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARK GOODMAN LCSW
Social Worker (Clinical)
62930 O B RILEY RD STE 200
BEND, OR 97703
Deschutes County (541) 330-1919
MS. AMY DINEEN LMFT
Marriage & Family Therapist
62930 O B RILEY RD STE 200
BEND, OR 97703
Deschutes County (541) 330-1919

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 Kristyn Prockish's NPI number?

The NPI number for Kristyn Prockish is 1164112827. It was assigned to this individual provider in the NPPES registry on May 8, 2023.

Where is Kristyn Prockish located?

Kristyn Prockish practices at 62930 O B Riley Rd Ste 200, Bend, OR 97703. The listed phone number is (541) 330-1919.

What is Kristyn Prockish's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Kristyn Prockish enrolled in Medicare?

Yes. Kristyn Prockish is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kristyn Prockish's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kristyn Prockish reassigns Medicare benefits to Optum Behavioral Care Of Colorado, P.C. (Eugene, OR). The 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 Kristyn Prockish's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kristyn Prockish accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Regence BlueCross BlueShield of Oregon list Kristyn Prockish 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 Kristyn Prockish was last updated on September 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.