Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelley Prokop

Individual provider Nurse Practitioner · NPI 1700167566

Kelley Prokop is a Nurse Practitioner in Worcester, Massachusetts. Qualified in 2011, 15 years ago. Practices with Umass Memorial Medical Group Inc, a 2,467-clinician group and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
15
Licensed in
MA
In the registry since
2011
Specialties on file
2
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Practice location Address checks out

55 Lake Ave N Dept OF Cardiology
Worcester, MA 01655-0002
Phone: (508) 334-3452
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence RN270270 (MA)
Nurse Practitioner Taxonomy 363L00000X · Licence RN270270 (MA)

Record details

NPI number1700167566
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 7, 2011
Last updated in NPPESMarch 8, 2022
Certification dateMarch 8, 2022
Mailing addressPo Box 415348, Boston, MA 02241-5348

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Umass Memorial Medical Group Inc — 2467 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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