DR. WIESLAW K. PROKOP (NPI# 1144212879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144212879 |
| Entity Type | Individual |
| Full Name | DR. WIESLAW K. PROKOP |
| Other Name | DR. WES PROKOP |
| Credential | M.D. |
| Practice Address |
15 Presidential Blvd Suite 100 Bala Cynwyd PA 19004-1000 |
| Mailing Address |
Po Box 237 Wynnewood PA 19096-0237 |
| Practice Telephone | 6107957366 |
| Practice Fax Number | 6106644749 |
| Mailing Telephone | 6107957366 |
| Mailing Fax Number | 6106644749 |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2012-06-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
MD419479 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 19053230001 | 05 |
| Street Address |
15 PRESIDENTIAL BLVD SUITE 100 |
| City | BALA CYNWYD |
| State | PA |
| Zip Code | 19004-1000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689976029 | Thomas J. Gerbner, Ph.d., Inc. | Psychologist | 15 Presidential Blvd, Suite 202, Bala Cynwyd, PA 19004-1006 | 2010-11-17 |
| 1437464773 | Emily F Pollard Md PC | Surgery | 15 Presidential Blvd, Suite 102, Bala Cynwyd, PA 19004-1006 | 2010-08-11 |
| 1174850903 | Zaki S Ftaiha | Plastic Surgery | 15 Presidential Blvd, Suite 200, Bala Cynwyd, PA 19004-1006 | 2009-11-16 |
| 1437383973 | Philadelphia Cosmetic Surgery Center | Plastic Surgery | 15 Presidential Blvd, Suite 200, Bala Cynwyd, PA 19004-1006 | 2009-05-12 |
| 1124209408 | Hamida Shirazy | Dentist | 15 Presidential Blvd, Suite#303, Bala Cynwyd, PA 19004-1006 | 2007-11-15 |
| 1083836712 | Thomas J. Gerbner | Psychologist | 15 Presidential Blvd, Suite 202, Bala Cynwyd, PA 19004-1006 | 2007-05-03 |
| 1205977402 | David Jacob Weinstock | Dentist | 15 Presidential Blvd, Suite 201, Bala Cynwyd, PA 19004-1006 | 2007-02-09 |
| 1235298472 | Ranti Aryani | Dentist | 15 Presidential Blvd, 303, Bala Cynwyd, PA 19004-1006 | 2006-12-06 |
| 1063582559 | Agata Lewkowska | Dentist | 15 Presidential Blvd, Suite #303, Bala Cynwyd, PA 19004-1006 | 2006-11-09 |
| 1477567782 | Bala Institute of Oral Surgery | Dentist | 15 Presidential Blvd, Suite 301, Bala Cynwyd, PA 19004-1006 | 2006-07-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831707819 | Katherine Lesher | Psychologist | 2 Bala Plaza Pl-13, Bala Plaza, PA 19004 | 2020-07-16 |
| 1144749342 | Apthcs | In Home Supportive Care | 150 Monument Road Suite 207, Bala Cynwyd, PA 19004 | 2017-09-19 |
| 1508389222 | Miriam Ray | Social Worker | 15 Montgomery Ave Apt 2b, Bala Cynwyd, PA 19004 | 2017-07-25 |
| 1003363235 | Catherine Kazanjian | Nurse Practitioner | 333 E City Ave Ste Il27, Bala Cynwyd, PA 19004 | 2016-09-06 |
| 1295181717 | Ruth Sampson-pilgrim | Nurse Practitioner | 160 Rock Hill Road, Vista Medical Services, Balacynwood, PA 19004 | 2016-05-13 |
| 1902252414 | Nurse Plus Home Care Agency,llc | In Home Supportive Care | Two Bala Plaza, Pmb #516, Suite 300, Bala Cynwyd, PA 19004 | 2016-05-13 |
| 1386010999 | Joan Lyall | Speech-Language Pathologist | 113 Ashland Avenue, Bala Cynwyd, PA 19004 | 2015-08-18 |
| 1922349158 | May W. Lee | Pediatrics | 130 E. Levering Mill Road, Bala Cynwyd, PA 19004 | 2013-03-13 |
| 1023362423 | Justin Carl Lavo | Physical Therapist | 100 Presidental Boulevard, Bala Cynwyd, PA 19004 | 2012-11-07 |
| 1689961765 | Cassio Castro | Dentist | 147 Montgomery Avenue, Bala Cynwyd, PA 19004 | 2011-07-08 |
| Find all providers in zip 19004 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093257776 | Philadelphia Smart Pain & Wellness, P.C. | Anesthesiology | 1 Bala Ave Ste 418, Bala Cynwyd, PA 19004-3207 | 2016-11-10 |
| 1780915736 | Wilhelmina Cornelia Korevaar | Anesthesiology | 1 Belmont Ave, Suite 315, Bala Cynwyd, PA 19004-1617 | 2010-01-14 |
| 1104852656 | Atlantic Pain and Wellness Institute PC | Anesthesiology | 2 Bala Plz, Pl#-50, Bala Cynwyd, PA 19004-1501 | 2006-06-25 |
| 1215963038 | Sanjay Gupta | Anesthesiology | 2 Bala Plz, Pl# 50, Bala Cynwyd, PA 19004-1501 | 2006-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629630504 | Bac Medical, Pllc | Anesthesiology | 3070 Bristol Pike # 2-130, Bensalem, PA 19020-5364 | 2019-07-01 |
| 1285294983 | Thomas Falasca | Anesthesiology | 411 Sybil Dr, Erie, PA 16505-2152 | 2019-06-17 |
| 1144711235 | Amy L. Croushore | Anesthesiology | 5750 Centre Ave Ste 400, Pittsburgh, PA 15206-3761 | 2018-05-23 |
| 1023521598 | Michaela R Lewis | Anesthesiology | 333 State St Ste 104, Erie, PA 16507-1463 | 2017-11-07 |
| 1457704652 | Guthrie Medical Group, P.C. | Anesthesiology | 37 Pratt Avenue, Towanda, PA 18848 | 2016-07-22 |
| 1932518669 | Pharo Pain Management Asociates, P.C. | Anesthesiology | 829 Spruce St Ste 308, Philadelphia, PA 19107-5752 | 2014-08-06 |
| 1457786253 | Lighthouse Medical, LLC | Anesthesiology | 507 Tire Hill Rd, Suite 100, Johnstown, PA 15905-7311 | 2013-09-11 |
| 1992137103 | Anish Sethi | Anesthesiology | 834 Chestnut St Ste T150, Philadelphia, PA 19107 | 2013-07-30 |
| 1528407392 | Soon Yong Jung | Anesthesiology | 1240 S Cedar Crest Blvd Ste 307, Allentown, PA 18103-6263 | 2013-06-14 |
| 1316381155 | Beacon Medical, LLC | Anesthesiology | 136 Jaycee Dr, Suite 10, Johnstown, PA 15904-3650 | 2013-04-23 |
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| City | BALA CYNWYD |
| Zip Code | 19004 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.