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LYNNETTE K PROKOP PA
NPI 1205292497
Physician Assistant - Surgical in Memphis, TN

Active since January 05, 2016PECOS EnrolledAccepts Medicare Assignment
1325 EASTMORELAND AVE STE 310, MEMPHIS, TN 38104(901) 758-7970(901) 266-6425 Get Directions Write a Review

NPPES record last updated: April 5, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 5, 2022, Jan 21, 2016 (2 updates tracked since 2016).

About Lynnette K Prokop Pa NPPES

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

LYNNETTE K PROKOP PA (NPI 1205292497) is an individual surgical provider in Memphis, Tennessee, licensed in Tennessee (4968) and active in the NPI registry since January 2016. She is enrolled in Medicare PECOS, is affiliated with Uh Cleveland Medical Center, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1205292497
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameLYNNETTE K PROKOPCredential: PA
Location Address1325 EASTMORELAND AVE STE 310Memphis, TN 38104-7544
Mailing Address1211 Union Ave Ste 330Memphis, TN 38104-6655 · (901) 758-7970 · Fax (901) 266-6425
Phone(901) 758-7970
Fax(901) 266-6425
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateJanuary 5, 2016
Last NPPES UpdateApril 5, 20222 updates tracked since enumeration
NPPES CertifiedApril 5, 2022
✔ NPI 1205292497 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in TN · 4968
Also ListedPhysician AssistantTaxonomy 363A00000X · License 50.004572RX (OH)
1325 EASTMORELAND AVE STE 310, Memphis, TN 38104
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lynnette K Prokop Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9537466503
PECOS Enrollment IDI20160318001860
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.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Uh Cleveland Medical Center

Acute Care Hospitals · Cleveland, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360137
Location11100 Euclid AvenueCleveland, OH 44106 · Cuyahoga County
Emergency services Birthing friendly

University Hospitals Ahuja Medical Center

Acute Care Hospitals · Beachwood, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360359
Location3999 Richmond RoadBeachwood, OH 44122 · Cuyahoga County
Emergency services

Other Providers at the Same Location NPPES 14

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

BAILEY ALYSSA FRY PA-S
Physician Assistant
1325 EASTMORELAND AVE STE 310
MEMPHIS, TN 38104
Shelby County (901) 516-7000
DR. MOHAMMAD KASHIF ISMAIL MD
Internal Medicine (Gastroenterology)
1325 EASTMORELAND AVE STE 310
MEMPHIS, TN 38104
Shelby County (901) 758-7970
MUSTAFA OMAMI MD
Surgery
1325 EASTMORELAND AVE STE 310
MEMPHIS, TN 38104
Shelby County (901) 758-7970
MEGAN STOVALL
Physician Assistant (Surgical)
1325 EASTMORELAND AVE STE 310
MEMPHIS, TN 38104
Shelby County (901) 758-7970
UT METHODIST PHYSICIANS LLC
Internal Medicine
1325 EASTMORELAND AVE STE 310
MEMPHIS, TN 38104
Shelby County (901) 758-7970
ALICIA A FARRIS FNP
Nurse Practitioner (Family)
1325 EASTMORELAND AVE STE 310
MEMPHIS, TN 38104
Shelby County (901) 272-6010
DR. MARY BRINSON OWENS M.D.
Surgery
1325 EASTMORELAND AVE STE 310
MEMPHIS, TN 38104
Shelby County (901) 758-7970
KAITLIN MICHELLE MCDANIEL PA-C
Physician Assistant (Surgical)
1325 EASTMORELAND AVE STE 310
MEMPHIS, TN 38104
Shelby County (901) 272-6010

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 Lynnette Prokop's NPI number?

The NPI number for Lynnette Prokop is 1205292497. It was assigned to this individual provider in the NPPES registry on January 5, 2016.

Where is Lynnette Prokop located?

Lynnette Prokop practices at 1325 Eastmoreland Ave Ste 310, Memphis, TN 38104. The listed phone number is (901) 758-7970.

What is Lynnette Prokop's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Lynnette Prokop enrolled in Medicare?

Yes. Lynnette Prokop is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Lynnette Prokop accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Antidote Health Plan of Ohio, Inc. and CareSource and 1 other insurer list Lynnette Prokop 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.

Is Lynnette Prokop affiliated with any hospitals?

According to CMS data, Lynnette Prokop is affiliated with Uh Cleveland Medical Center and University Hospitals Ahuja Medical Center.

When was this NPI record last updated?

The NPPES record for Lynnette Prokop was last updated on April 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.