LYNNETTE K PROKOP (PA) – Surgical Physician Assistant, NPI 1205292497
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,036 PHYSICIAN ASSISTANT in OH
Provider Addresses for LYNNETTE K PROKOP (PA)
1362 MANATEE AVE
MADISON, OH 440571224
Phone: (440) 796-0801
Type: Mailing
9485 MENTOR AVE
#100
MENTOR, OH 440604597
Phone: (440) 205-5750
Fax: (440) 205-5752
Type: Location
1325 EASTMORELAND AVE STE 310
MEMPHIS, TN 381047544
Phone: (901) 758-7970
Fax: (901) 266-6425
Type: Location
1211 UNION AVE STE 330
MEMPHIS, TN 381046655
Phone: (901) 758-7970
Fax: (901) 266-6425
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $100.
Total Amount is formed as General ($100) + Research ($0) + Ownership ($0) = $100.
Last reported payment date: 2023-05-03 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($100).
Total Amount
$100
General + Research + Ownership
Payments
1
Total payment records
General Amount
$100
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Intuitive Surgical, Inc. | $100 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-04-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160318001860 | I | Physician Assistant | OH | TBD |
| I20220413001292 | I | Physician Assistant | TN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 44057)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | OH | 27447 | Repair of knee joint | 12 | 11 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OH | |
| - | MI | |
| Hospitalist, Internal Medicine | OH | |
| - | TX | |
| - | OH | |
| Certified Registered Nurse Anesthetist (Crna) | OH | |
| - | OH | |
| O B S T E T R I C S/ G Y N E C O L O G Y | OH | |
| - | OH | |
| - | OH |
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