Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jack Prothero, PA-C

Individual provider Surgical Physician Assistant · NPI 1851279962

Jack Prothero, PA-C is a Physician Assistant in Monroeville, Pennsylvania. Qualified in 2025, 1 year ago. Practices with Allegheny Clinic, a 2,300-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
1
Licensed in
PA
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2566 Haymaker Rd Ste 304
Monroeville, PA 15146-3555
Phone: (412) 858-3070
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence MA067306 (PA)

Record details

NPI number1851279962
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedAugust 26, 2025
Last updated in NPPESDecember 16, 2025
Certification dateDecember 16, 2025
Mailing address2566 Haymaker Rd Ste 304, Monroeville, PA 15146-3555

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Allegheny Clinic — 2300 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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