JACK PROTHERO PA-C
NPI 1851279962
Physician Assistant - Surgical in Monroeville, PA

Active since August 26, 2025PECOS EnrolledAccepts Medicare Assignment
2566 HAYMAKER RD STE 304, MONROEVILLE, PA 15146(412) 858-3070 Get Directions Write a Review

NPPES record last updated: December 16, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jack Prothero Pa-c NPPES

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

JACK PROTHERO PA-C (NPI 1851279962) is an individual surgical provider in Monroeville, Pennsylvania, licensed in Pennsylvania (MA067306) and active in the NPI registry since August 2025. He is enrolled in Medicare PECOS, is affiliated with Forbes Hospital, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1851279962
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameJACK PROTHEROCredential: PA-C
Location Address2566 HAYMAKER RD STE 304Monroeville, PA 15146-3555
Mailing Address2566 Haymaker Rd Ste 304Monroeville, PA 15146-3555 · (412) 858-3070
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateAugust 26, 2025
Last NPPES UpdateDecember 16, 2025
NPPES CertifiedDecember 16, 2025
NPI 1851279962 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License Licensed in PA · MA067306
2566 HAYMAKER RD STE 304, Monroeville, PA 15146

Other Identifiers 1

Other16688712Caqh

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

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

Jack Prothero Pa-c 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 ID143716175
PECOS Enrollment IDI20251230000699
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

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

Forbes Hospital

Acute Care Hospitals · Monroeville, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390267
Location2570 Haymaker RoadMonroeville, PA 15146 · Allegheny County
Emergency services Birthing friendly

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.

Physician Assistant (Surgical)
2566 HAYMAKER RD STE 304
MONROEVILLE, PA 15146
Physician Assistant (Surgical)
2566 HAYMAKER RD STE 304
MONROEVILLE, PA 15146
Colon & Rectal Surgery
2566 HAYMAKER RD STE 304
MONROEVILLE, PA 15146
Physician Assistant (Surgical)
2566 HAYMAKER RD STE 304
MONROEVILLE, PA 15146
Colon & Rectal Surgery
2566 HAYMAKER RD STE 304
MONROEVILLE, PA 15146
Surgery (Surgical Critical Care)
2566 HAYMAKER RD STE 304
MONROEVILLE, PA 15146
Physician Assistant (Surgical)
2566 HAYMAKER RD STE 304
MONROEVILLE, PA 15146
Nurse Practitioner (Acute Care)
2566 HAYMAKER RD STE 304
MONROEVILLE, PA 15146

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 Jack Prothero's NPI number?

The NPI number for Jack Prothero is 1851279962. It was assigned to this individual provider in the NPPES registry on August 26, 2025.

Where is Jack Prothero located?

Jack Prothero practices at 2566 Haymaker Rd Ste 304, Monroeville, PA 15146. The listed phone number is (412) 858-3070.

What is Jack Prothero's specialty?

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

Is Jack Prothero enrolled in Medicare?

Yes. Jack Prothero 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.

Is Jack Prothero affiliated with any hospitals?

According to CMS data, Jack Prothero is affiliated with Forbes Hospital.

When was this NPI record last updated?

The NPPES record for Jack Prothero was last updated on December 16, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.