JESSICA PROM MD
NPI 1659165413
Student in an Organized Health Care Education/Training Program in Milwaukee, WI
About Jessica Prom Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JESSICA PROM MD (NPI 1659165413) is an individual student in an organized health care education/training program in Milwaukee, Wisconsin and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jessica Prom Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
WAUWATOSA, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
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 Jessica Prom's NPI number?
The NPI number for Jessica Prom is 1659165413. It was assigned to this individual provider in the NPPES registry on April 7, 2025.
Where is Jessica Prom located?
Jessica Prom practices at 8701 Watertown Plank Rd, Milwaukee, WI 53226. The listed phone number is (414) 955-4575.
What is Jessica Prom's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Jessica Prom enrolled in Medicare?
Yes. Jessica Prom is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Jessica Prom was last updated on April 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Jessica Prom, MD · NPI 1659165413
Student in an Organized Health Care Education/Training Program provider in Milwaukee, Wisconsin. Individual provider, active in the CMS NPPES registry since April 7, 2025.
## Identity
- **NPI:** 1659165413 (Entity type: Individual)
- **Enumerated:** April 7, 2025
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 8701 WATERTOWN PLANK RD, Milwaukee, WI 53226-3548
- **Phone:** (414) 955-4575
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** April 7, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1659165413) · Data from the CMS NPPES public registry.